Healthcare Provider Details

I. General information

NPI: 1578133237
Provider Name (Legal Business Name): CAREPOINT EMERGENCY MEDICINE KANSAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2021
Last Update Date: 06/25/2021
Certification Date: 06/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 N WOODLAWN BLVD
WICHITA KS
67220-2729
US

IV. Provider business mailing address

PO BOX 5607
DENVER CO
80217-5607
US

V. Phone/Fax

Practice location:
  • Phone: 316-858-2610
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH SMITH
Title or Position: VP/LEGAL COUNSEL
Credential:
Phone: 303-436-2720