Healthcare Provider Details

I. General information

NPI: 1881673440
Provider Name (Legal Business Name): DANIEL J HEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 03/06/2020
Certification Date: 03/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 N WOODLAWN BLVD
WICHITA KS
67220-2729
US

IV. Provider business mailing address

1230 E 6TH AVE STE 1B
WINFIELD KS
67156-3144
US

V. Phone/Fax

Practice location:
  • Phone: 316-858-2610
  • Fax: 316-858-2793
Mailing address:
  • Phone: 316-858-2610
  • Fax: 316-858-2793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number04-23682
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number04-23682
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: