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General NPI Number Information
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NPI Number | 1386624518
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Entity Type | Organization
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Legal Business Name | HEARTLAND PATHOLOGY PA
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 9300 E 29TH ST N SUITE 208
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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 | 316-636-5666
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Fax | 316-652-0340
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Provider Business Mailing Address
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Address Line | PO BOX 3462
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City | WICHITA
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State | KS
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Zip | 67201-3462
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Country | US
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Telephone | 316-685-6236
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Fax | 316-652-0340
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Authorized Official
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Title or Position | PRESIDENT
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Name | HANA RAZEK
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Credential | MD
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Telephone | 316-636-5666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine 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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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