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General NPI Number Information
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NPI Number | 1033178108
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Entity Type | Individual
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Provider Name | DONALD C S TAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 817 N EMPORIA ST VIA CHRISTI CANCER CENTER
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City | WICHITA
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State | KS
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Zip | 67214
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Country | US
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Telephone | 316-268-5927
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Fax |
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Provider Business Mailing Address
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Address Line | 551 N HILLSIDE ST STE 320
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City | WICHITA
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State | KS
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Zip | 67214
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Country | US
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Telephone | 316-685-1367
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Fax | 316-685-1436
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 0422757
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License Number State | KS
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