Healthcare Provider Details

I. General information

NPI: 1194986109
Provider Name (Legal Business Name): NELSON HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 N SAINT FRANCIS ST EMERGENCY DEPT.
WICHITA KS
67214-3821
US

IV. Provider business mailing address

929 N SAINT FRANCIS ST EMERGENCY DEPT.
WICHITA KS
67214-3821
US

V. Phone/Fax

Practice location:
  • Phone: 316-268-5775
  • Fax: 316-291-7496
Mailing address:
  • Phone: 316-268-5775
  • Fax: 316-291-7496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number04-34965
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number16942
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: