Healthcare Provider Details
I. General information
NPI: 1598825606
Provider Name (Legal Business Name): WHOLEWOMAN CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1150 N SAINT FRANCIS ST
WICHITA KS
67214-2814
US
IV. Provider business mailing address
1150 N SAINT FRANCIS ST
WICHITA KS
67214-2814
US
V. Phone/Fax
- Phone: 316-265-3800
- Fax: 316-265-3801
- Phone: 316-265-3800
- Fax: 316-265-3801
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 05-20200 |
| License Number State | KS |
VIII. Authorized Official
Name: DR.
LESLIE
E. F.
PAGE
Title or Position: OWNER
Credential: D.O.
Phone: 316-265-3800