Healthcare Provider Details

I. General information

NPI: 1548093339
Provider Name (Legal Business Name): PREMIER HOSPITALISTS OF KANSAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 W CENTRAL AVE
WICHITA KS
67203-4921
US

IV. Provider business mailing address

3515 W CENTRAL AVE
WICHITA KS
67203-4921
US

V. Phone/Fax

Practice location:
  • Phone: 316-755-0144
  • Fax: 844-274-1204
Mailing address:
  • Phone: 316-755-0144
  • Fax: 844-274-1204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH RIAN BURNS
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 316-755-0144