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General NPI Number Information
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NPI Number | 1386070779
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Entity Type | Organization
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Legal Business Name | HEARTLAND RESEARCH ASSOCIATES, LLC
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Dates
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Enumeration Date | 09/18/2013
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Last Update Date | 09/18/2013
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Provider Practice Location Address
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Address Line | 1709 S ROCK RD
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City | WICHITA
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State | KS
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Zip | 67207-5150
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Country | US
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Telephone | 316-689-6629
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Fax | 316-689-6690
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Provider Business Mailing Address
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Address Line | 1709 S ROCK RD
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City | WICHITA
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State | KS
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Zip | 67207-5150
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Country | US
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Telephone | 316-689-6629
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Fax | 316-689-6690
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. TERRY POLING
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Credential | MD
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Telephone | 316-686-6629
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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 | KS
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