Provider Demographics
NPI:1649370032
Name:GREEN, RHONDA JEAN (MD)
Entity type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:JEAN
Last Name:GREEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RHONDA
Other - Middle Name:JEAN
Other - Last Name:BEESON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:510 W RADIO LN
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005-4011
Mailing Address - Country:US
Mailing Address - Phone:620-442-2100
Mailing Address - Fax:620-442-8945
Practice Address - Street 1:510 W RADIO LN
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-4011
Practice Address - Country:US
Practice Address - Phone:580-762-9355
Practice Address - Fax:580-762-3547
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-29171207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS080175482OtherRAILROAD MEDICARE
KS100400730AMedicaid
KS9843OtherPPK
KS415880OtherFIRSTGUARD