Healthcare Provider Details
I. General information
NPI: 1952593915
Provider Name (Legal Business Name): ASCENSION MEDICAL GROUP VIA CHRISTI, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2007
Last Update Date: 03/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
750 N SOCORA ST SUITE 100
WICHITA KS
67212-3793
US
IV. Provider business mailing address
750 N SOCORA ST SUITE 100
WICHITA KS
67212-3793
US
V. Phone/Fax
- Phone: 316-946-1790
- Fax:
- Phone: 316-946-1790
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QS1200X |
| Taxonomy | Sleep Disorder Diagnostic Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SUZANN
M
WRIGHT
Title or Position: DIRECTOR,PATIENT FINANCIAL SERVICES
Credential:
Phone: 316-719-1201