Healthcare Provider Details

I. General information

NPI: 1811958044
Provider Name (Legal Business Name): MARK B STEFFEN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 09/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 CLEVELAND ST
GREAT BEND KS
67530-3562
US

IV. Provider business mailing address

3500 N MAYFIELD RD
HUTCHINSON KS
67502-9461
US

V. Phone/Fax

Practice location:
  • Phone: 620-791-6215
  • Fax:
Mailing address:
  • Phone: 620-791-6215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK STEFFEN
Title or Position: PRESIDENT
Credential: MD
Phone: 620-791-6215