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General NPI Number Information
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NPI Number | 1174617039
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Entity Type | Individual
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Provider Name | ERIC NORDLING DO
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8925 W MAPLE ST
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City | WICHITA
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State | KS
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Zip | 67209-1462
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Country | US
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Telephone | 316-721-3271
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Fax | 316-721-9643
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Provider Business Mailing Address
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Address Line | PO BOX 47403
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City | WICHITA
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State | KS
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Zip | 67201-7403
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Country | US
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Telephone | 316-683-9926
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Fax | 316-686-2418
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 0530411
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License Number State | KS
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