Healthcare Provider Details

I. General information

NPI: 1154302180
Provider Name (Legal Business Name): WICHITA SURGICAL SPECIALISTS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

551 N HILLSIDE ST STE 201
WICHITA KS
67214-4925
US

V. Phone/Fax

Practice location:
  • Phone: 316-300-2571
  • Fax: 316-263-9523
Mailing address:
  • Phone: 316-300-2571
  • Fax: 316-263-9523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number0417170
License Number StateKS
# 5
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number0419421
License Number StateKS
# 6
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number0429036
License Number StateKS
# 7
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number0419826
License Number StateKS
# 8
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number0421808
License Number StateKS
# 9
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number0419546
License Number StateKS
# 10
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0418698
License Number StateKS

VIII. Authorized Official

Name: DR. ALEX D AMMAR
Title or Position: CEO
Credential: MD
Phone: 316-263-0296