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General NPI Number Information
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NPI Number | 1255398673
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Entity Type | Organization
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Legal Business Name | CYPRESS HEART, PA
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 09/07/2010
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Provider Practice Location Address
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Address Line | 9300 E 29TH ST N SUITE 310
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City | WICHITA
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State | KS
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Zip | 67226-2182
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Country | US
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Telephone | 316-858-9000
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Fax | 316-858-9005
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Provider Business Mailing Address
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Address Line | PO BOX 25943
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City | OKLAHOMA CITY
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State | OK
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Zip | 73125-0943
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Country | US
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Telephone | 316-858-9000
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Fax | 316-858-9005
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROGER WILLIAMS EVANS
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Credential | MD
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Telephone | 316-858-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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