Healthcare Provider Details
I. General information
NPI: 1417825795
Provider Name (Legal Business Name): GARDEN CITY OB/GYN, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/28/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
409 N CAMPUS DR STE 108
GARDEN CITY KS
67846-6158
US
IV. Provider business mailing address
409 N CAMPUS DR STE 108
GARDEN CITY KS
67846-6158
US
V. Phone/Fax
- Phone: 620-805-2308
- Fax:
- 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 | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BRET
EARL
HESKETT
Title or Position: PHYSICIAN
Credential: MD
Phone: 620-805-2308