Healthcare Provider Details

I. General information

NPI: 1346220837
Provider Name (Legal Business Name): CHANDRA SEKHAR TOKALA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 02/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3223 N. WEBB ROAD SUITE 5
WICHITA KS
67226-8176
US

IV. Provider business mailing address

PO BOX 3547
WICHITA KS
67201-3547
US

V. Phone/Fax

Practice location:
  • Phone: 316-618-8305
  • Fax: 316-315-0514
Mailing address:
  • Phone: 316-618-8305
  • Fax: 316-315-0514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number04-29152
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number04-29152
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: