Healthcare Provider Details

I. General information

NPI: 1306290879
Provider Name (Legal Business Name): TITAN MEDICAL BILLING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 04/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 W 31ST ST S
WICHITA KS
67217-2500
US

IV. Provider business mailing address

1401 W 31ST ST S
WICHITA KS
67217-2500
US

V. Phone/Fax

Practice location:
  • Phone: 316-882-5353
  • Fax: 316-529-0200
Mailing address:
  • Phone: 316-882-5353
  • Fax: 316-529-0200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. TIMOTHY WARREN
Title or Position: OWNER/AUTHORIZED OFFICIAL
Credential: DC
Phone: 316-882-5353