Healthcare Provider Details

I. General information

NPI: 1821067893
Provider Name (Legal Business Name): HEARTLAND ANESTHESIA ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10014 W GREENSPOINT ST
WICHITA KS
67205-1581
US

IV. Provider business mailing address

PO BOX 1148
WICHITA KS
67201-1148
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DOUGLAS FRIESEN
Title or Position: PRESIDENT
Credential: MD
Phone: 316-685-3698