Healthcare Provider Details

I. General information

NPI: 1396712485
Provider Name (Legal Business Name): MIDWEST PAIN MANAGEMENT CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1708 E 23RD AVE
HUTCHINSON KS
67502-1114
US

IV. Provider business mailing address

PO BOX 3148
WICHITA KS
67201-3148
US

V. Phone/Fax

Practice location:
  • Phone: 620-665-2000
  • Fax:
Mailing address:
  • Phone: 316-685-3698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DOUGLAS FRIESEN
Title or Position: PRESIDENT
Credential: MD
Phone: 620-665-2000