Healthcare Provider Details

I. General information

NPI: 1114919859
Provider Name (Legal Business Name): DIAGNOSTIC ULTRASOUND SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7829 E ROCKHILL ST
WICHITA KS
67206-3914
US

IV. Provider business mailing address

PO BOX 9023
WICHITA KS
67277-0023
US

V. Phone/Fax

Practice location:
  • Phone: 316-558-8660
  • Fax:
Mailing address:
  • Phone: 316-558-8660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DOREN DWAIN RHOADES
Title or Position: OWNER/CEO/CFO
Credential:
Phone: 316-250-9488