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General NPI Number Information
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NPI Number | 1609342385
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Entity Type | Organization
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Legal Business Name | AIR CAPITAL EMERGENCY SERVICES, LLC
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Dates
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Enumeration Date | 10/19/2018
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Last Update Date | 10/19/2018
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Provider Practice Location Address
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Address Line | 720 W CENTRAL AVE
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City | EL DORADO
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State | KS
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Zip | 67042-2112
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Country | US
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Telephone | 316-322-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 1518 N TERHUNE ST
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City | WICHITA
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State | KS
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Zip | 67230-7243
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW MOLL
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Credential |
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Telephone | 316-371-9449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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