| Doctor Name: | MARION SUSAN RODGMAN |
| NPI Number: | 1649411158 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 04-25143 |
| Business Practice Address: | 3520 Lakin Ave Suite 103 Great Bend, KS - 675303660 |
| Business Phone Number: | 6207923345 |
| Business Fax Number: | 6207923767 |
| Mailing Address: | Po Box 969, GREAT BEND |
| State: | KS |
| Postal Code: | 675300969 |
| Phone Number: | 6207866475 |
| Fax Number: | 6207866155 |
| NPI Enumeration Date: | 03/12/2009 |
| NPI Last Update Date: | 11/03/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 04-25143 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |