Provider Demographics
NPI:1689081267
Name:MARTS, JEFF (PHARMD)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:MARTS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8828 W 13TH ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-4030
Mailing Address - Country:US
Mailing Address - Phone:316-722-9733
Mailing Address - Fax:316-729-1505
Practice Address - Street 1:8828 W 13TH ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-4030
Practice Address - Country:US
Practice Address - Phone:316-722-9733
Practice Address - Fax:316-729-1505
Is Sole Proprietor?:No
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-12900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist