Healthcare Provider Details

I. General information

NPI: 1386535672
Provider Name (Legal Business Name): HEARTLAND PLASTIC SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4817 E DOUGLAS AVE STE 200
WICHITA KS
67218-1019
US

IV. Provider business mailing address

4817 E DOUGLAS AVE STE 200
WICHITA KS
67218-1019
US

V. Phone/Fax

Practice location:
  • Phone: 316-241-8363
  • Fax:
Mailing address:
  • Phone: 316-241-8363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: NATALIYA BISKUP
Title or Position: OWNER
Credential: MD
Phone: 316-241-8363