Healthcare Provider Details

I. General information

NPI: 1699981399
Provider Name (Legal Business Name): VISION 2000 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 N AMIDON AVE STE 13
WICHITA KS
67203-2100
US

IV. Provider business mailing address

PO BOX 781838
WICHITA KS
67278-1838
US

V. Phone/Fax

Practice location:
  • Phone: 316-832-1558
  • Fax:
Mailing address:
  • Phone: 316-832-1558
  • 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: ALAN L BURKE
Title or Position: CEO
Credential:
Phone: 316-371-6936