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General NPI Number Information
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NPI Number | 1659346245
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Entity Type | Individual
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Provider Name | SAMUEL W AMSTUTZ MD
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Gender | Male
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Dates
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Enumeration Date | 02/17/2006
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Last Update Date | 01/29/2018
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Provider Practice Location Address
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Address Line | 655 N WOODLAWN
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City | WICHITA
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State | KS
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Zip | 67208
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Country | US
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Telephone | 316-684-5158
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Fax | 316-681-1005
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Provider Business Mailing Address
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Address Line | 1851 N WEBB RD ATTN FLR2
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City | WICHITA
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State | KS
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Zip | 67206-3413
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Country | US
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Telephone | 316-636-2010
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Fax | 316-858-3830
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0421085
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207WX0200X
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Taxonomy Name | Ophthalmic Plastic and Reconstructive Surgery Physician
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License Number | 04-21085
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License Number State | KS
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