Healthcare Provider Details
I. General information
NPI: 1306054952
Provider Name (Legal Business Name): BRET E HESKETT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/18/2007
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
712A SAINT JOHN ST
GARDEN CITY KS
67846-5128
US
IV. Provider business mailing address
2090 MILFORD LN
GARDEN CITY KS
67846-8341
US
V. Phone/Fax
- Phone: 620-275-1766
- Fax: 620-275-4729
- Phone: 620-805-2308
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 04-34977 |
| License Number State | KS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: