Healthcare Provider Details

I. General information

NPI: 1306071303
Provider Name (Legal Business Name): PREFERRED MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2009
Last Update Date: 07/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

848 N SAINT FRANCIS ST STE. 2968
WICHITA KS
67214-3800
US

IV. Provider business mailing address

848 N SAINT FRANCIS ST STE. 2968
WICHITA KS
67214-3800
US

V. Phone/Fax

Practice location:
  • Phone: 316-269-1717
  • Fax: 316-291-7317
Mailing address:
  • Phone: 316-269-1717
  • Fax: 316-291-7317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number04-33591
License Number StateKS

VIII. Authorized Official

Name: DR. EDWARD J HETT
Title or Position: PRESIDENT
Credential: MD
Phone: 316-268-8080