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General NPI Number Information
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NPI Number | 1457417370
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Entity Type | Organization
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Legal Business Name | LYLE ZEPICK, M.D. P.A.
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 08/27/2010
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Provider Practice Location Address
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Address Line | 630 S HILLSIDE ST
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City | WICHITA
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State | KS
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Zip | 67211-2157
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Country | US
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Telephone | 316-491-5926
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Fax | 316-491-5962
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Provider Business Mailing Address
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Address Line | PO BOX 47624
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City | WICHITA
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State | KS
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Zip | 67201-7624
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Country | US
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Telephone | 316-491-5926
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Fax | 316-491-5962
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Authorized Official
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Title or Position | OWNER
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Name | LYLE ZEPICK
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Credential | M.D.
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Telephone | 316-616-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 04-19176
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License Number State | KS
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