Healthcare Provider Details

I. General information

NPI: 1174904247
Provider Name (Legal Business Name): ROXANNE N MCGINN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROXANNE N STILES MD

II. Dates (important events)

Enumeration Date: 06/15/2015
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 CLEVELAND ST
GREAT BEND KS
67530-3562
US

IV. Provider business mailing address

PO BOX 412
CLAFLIN KS
67525-0412
US

V. Phone/Fax

Practice location:
  • Phone: 620-282-8823
  • Fax:
Mailing address:
  • Phone: 620-282-8823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number04-44802
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: