=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134109523
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MIDWEST SURGERY CENTER, L.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/20/2006
-----------------------------------------------------
Last Update Date | 06/02/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 825 N HILLSIDE ST SUITE 100
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67214-4913
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-683-3937
-----------------------------------------------------
Fax | 316-683-1030
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 825 N HILLSIDE ST SUITE 100
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67214-4913
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-683-3937
-----------------------------------------------------
Fax | 316-683-1030
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | C.E.O.
-----------------------------------------------------
Name | DR. THOMAS FRIMPONG
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 316-683-3937
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA1903X
-----------------------------------------------------
Taxonomy Name | Ambulatory Surgical Clinic/Center
-----------------------------------------------------
License Number | S087013
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------