Healthcare Provider Details

I. General information

NPI: 1497450274
Provider Name (Legal Business Name): HEIDI LEANNE PAGE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 N RIDGE RD
WICHITA KS
67212-1570
US

IV. Provider business mailing address

2101 N WALDRON ST
HUTCHINSON KS
67502-1131
US

V. Phone/Fax

Practice location:
  • Phone: 316-773-1212
  • Fax: 316-440-6601
Mailing address:
  • Phone: 620-669-2500
  • Fax: 620-669-2501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number04-53833
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: