Healthcare Provider Details

I. General information

NPI: 1932417961
Provider Name (Legal Business Name): HUTCHINSON CARDIAC SURGERY, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2010
Last Update Date: 09/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 E 23RD AVE
HUTCHINSON KS
67502-1105
US

IV. Provider business mailing address

PO BOX 2886
HUTCHINSON KS
67504-2886
US

V. Phone/Fax

Practice location:
  • Phone: 620-665-2183
  • Fax:
Mailing address:
  • Phone: 913-642-4900
  • Fax: 913-381-0979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: JONAS HEINRICH
Title or Position: CREDENTIALS COORDINATOR
Credential:
Phone: 913-642-4900