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NPI Code Detail

MEDICARE: THE PROSTATE TREATMENT CENTER

MEDICARE: THE PROSTATE TREATMENT CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology Physician0430440KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1111124OTHERKSBCBS

General Provider Information

NPI Number : 1417169889
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE PROSTATE TREATMENT CENTER
Provider Business Mailing Address
First Line : 1130 S CLIFTON AVE
Second Line :
City : WICHITA
State : KS
Zip : 67218-2913
Country : US
Telephone Number : 316-269-5000
Fax Number : 316-269-0404
Provider Business Practice Location Address
First Line : 1130 S CLIFTON AVE
Second Line :
City : WICHITA
State : KS
Zip : 67218-2913
Country : US
Telephone Number : 316-269-5000
Fax Number : 316-269-0404
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : RODNEY HANDSFIELD
Credential : M.D.
Telephone Number : 316-269-5000
Provider Enumeration Date : 05/05/2007
Last Update Date : 08/22/2020

Similar Medicare Providers

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Practice Location Address:
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1053335927 — DR. MICHAEL LYNN JACOBSEN DDS
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1184736118 — RODNEY G HANDSFIELD M.D.
Practice Location Address:
1130 S CLIFTON AVE
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1831485317 — NICHOLAS ANDREW TOMSEN MD
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Directions to “THE PROSTATE TREATMENT CENTER ” Practice Location

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