Healthcare Provider Details

I. General information

NPI: 1619934312
Provider Name (Legal Business Name): REGIONAL SURGICAL ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 LAKIN AVE
GREAT BEND KS
67530-3646
US

IV. Provider business mailing address

3520 LAKIN AVE
GREAT BEND KS
67530-3646
US

V. Phone/Fax

Practice location:
  • Phone: 620-792-1227
  • Fax: 620-792-8029
Mailing address:
  • Phone: 620-792-1227
  • Fax: 620-792-8029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MERLIN G KIRBY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 620-792-1227