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General NPI Number Information
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NPI Number | 1700840907
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Entity Type | Organization
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Legal Business Name | ROBERT L. EYSTER, MD, PA
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Dates
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Enumeration Date | 04/14/2006
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Last Update Date | 08/06/2010
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Provider Practice Location Address
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Address Line | 1131 S CLIFTON AVE
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City | WICHITA
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State | KS
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Zip | 67218-2955
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Country | US
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Telephone | 316-858-1600
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Fax | 316-858-1601
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Provider Business Mailing Address
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Address Line | 1131 S CLIFTON AVE
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City | WICHITA
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State | KS
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Zip | 67218-2955
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Country | US
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Telephone | 316-858-1600
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Fax | 316-858-1601
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. MICHAEL D RAMSEY
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Credential | R.P.A.C
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Telephone | 316-858-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0415948
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License Number State | KS
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