Premier Ob-Gyn LLC

NPI #1184098212 in Great Bend, Kansas

Provider Information

NPI Number: 1184098212
Entity Type: Organization
Organization Name: Premier Ob-Gyn LLC
Primary Specialty: Obstetrics & Gynecology
Enumeration Date: Dec 1, 2015
Last Updated: Dec 1, 2015

Practice Location

Address: 514 CLEVELAND ST
City: Great Bend
State: Kansas
ZIP Code: 67530-3562
Phone: (620) 792-2151

Authorized Official

Name: JODI L HENRIKSON, MD
Title: PHYSICIAN
Phone: (620) 792-2151

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X	Primary

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