Healthcare Provider Details

I. General information

NPI: 1609803725
Provider Name (Legal Business Name): JAMES M. HAAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 N EMPORIA ST STE 200
WICHITA KS
67214-3788
US

IV. Provider business mailing address

551 N HILLSIDE ST STE 201
WICHITA KS
67214-4923
US

V. Phone/Fax

Practice location:
  • Phone: 316-263-0296
  • Fax: 316-263-9523
Mailing address:
  • Phone: 316-263-0296
  • Fax: 316-263-9523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberD53731
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number04.33118
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberD53731
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number04.33118
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: