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General NPI Number Information
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NPI Number | 1215016605
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Entity Type | Organization
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Legal Business Name | SOUTHEAST FAMILY HEALTH CARE P A
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Dates
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Enumeration Date | 11/04/2006
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Last Update Date | 11/12/2009
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Provider Practice Location Address
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Address Line | 990 S GEORGE WASHINGTON DR
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City | WICHITA
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State | KS
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Zip | 67211-3900
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Country | US
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Telephone | 316-686-2111
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Fax | 316-686-3659
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Provider Business Mailing Address
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Address Line | 990 S GEORGE WASHINGTON DR
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City | WICHITA
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State | KS
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Zip | 67211-3900
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Country | US
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Telephone | 316-686-2111
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Fax | 316-686-3659
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JAMES MICHAEL PATTON
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Credential | MD
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Telephone | 316-686-2111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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