Healthcare Provider Details

I. General information

NPI: 1497802896
Provider Name (Legal Business Name): WOMENS HEALTH & CONTINENCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7015 E CENTRAL AVE STE. #100
WICHITA KS
67206-1943
US

IV. Provider business mailing address

7015 E CENTRAL AVE STE. #100
WICHITA KS
67206-1943
US

V. Phone/Fax

Practice location:
  • Phone: 316-260-3950
  • Fax: 316-260-3953
Mailing address:
  • Phone: 316-260-3950
  • Fax: 316-260-3953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number0523677
License Number StateKS

VIII. Authorized Official

Name: DR. DAVID BRYANT SHUCK
Title or Position: OWNER
Credential: DO
Phone: 316-260-3950