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General NPI Number Information
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NPI Number | 1417993304
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Entity Type | Organization
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Legal Business Name | WICHITA INFECTIOUS DISEASE, P.A.
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 08/09/2007
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Provider Practice Location Address
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Address Line | 929 N SAINT FRANCIS ST
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City | WICHITA
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State | KS
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Zip | 67214-3821
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Country | US
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Telephone | 316-268-5050
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Fax |
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Provider Business Mailing Address
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Address Line | 155 N MARKET ST SUITE 950
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City | WICHITA
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State | KS
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Zip | 67202-1816
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Country | US
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Telephone | 316-269-5000
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Fax | 316-269-0404
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Authorized Official
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Title or Position | MANAGER
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Name | GEORGIA DENNE
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Credential |
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Telephone | 316-269-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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