Healthcare Provider Details

I. General information

NPI: 1902473846
Provider Name (Legal Business Name): YEGOR PASHCHENKO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 S US HIGHWAY 59
PARSONS KS
67357-4948
US

IV. Provider business mailing address

1010 N KANSAS ST
WICHITA KS
67214-3124
US

V. Phone/Fax

Practice location:
  • Phone: 620-820-5840
  • Fax:
Mailing address:
  • Phone: 316-293-2665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number04-54094
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: