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General NPI Number Information
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NPI Number | 1093964736
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Entity Type | Individual
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Provider Name | KYLE BARRON VINCENT M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/18/2008
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Last Update Date | 08/06/2015
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Provider Practice Location Address
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Address Line | 1947 FOUNDERS CIRCLE
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City | WICHITA
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State | KS
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Zip | 67206-0000
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Country | US
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Telephone | 316-613-4707
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Fax | 316-613-4608
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Provider Business Mailing Address
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Address Line | PO BOX 8035
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City | WICHITA
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State | KS
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Zip | 67208-0035
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Country | US
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Telephone | 316-689-9135
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 04-34936
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License Number State | KS
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