Healthcare Provider Details

I. General information

NPI: 1093868457
Provider Name (Legal Business Name): RICHARD S. TOON, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 01/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 N WOODLAWN ST
WICHITA KS
67220-2729
US

IV. Provider business mailing address

2600 N WOODLAWN ST
WICHITA KS
67220-2729
US

V. Phone/Fax

Practice location:
  • Phone: 316-684-3838
  • Fax: 316-858-2521
Mailing address:
  • Phone: 316-684-3838
  • Fax: 316-858-2521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD S. TOON
Title or Position: PRESIDENT, SECRETARY
Credential: M.D.
Phone: 316-684-3838