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General NPI Number Information
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NPI Number | 1518618958
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Entity Type | Organization
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Legal Business Name | MEDICAL ON DEMAND LLC
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 03/18/2026
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Provider Practice Location Address
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Address Line | 10346 E STONEGATE LN STE 100
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City | WICHITA
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State | KS
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Zip | 67206-2054
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Country | US
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Telephone | 316-871-0995
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Fax |
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Provider Business Mailing Address
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Address Line | 326 N WABASH AVE
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City | WICHITA
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State | KS
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Zip | 67214-3948
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Country | US
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Telephone | 316-871-0995
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Fax | 833-903-3589
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Authorized Official
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Title or Position | OWNER
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Name | DR. JUSTIN GOODEN
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Credential | MD
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Telephone | 316-871-0995
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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 |
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