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General NPI Number Information
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NPI Number | 1821099805
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Entity Type | Individual
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Provider Name | GLENN RICHARD KUBINA MD
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Gender | Male
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 310 S HILLSIDE ST
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City | WICHITA
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State | KS
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Zip | 67211-2193
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Country | US
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Telephone | 316-684-2838
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Fax | 316-684-3326
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Provider Business Mailing Address
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Address Line | 818 N EMPORIA STE 200
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City | WICHITA
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State | KS
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Zip | 67214-2193
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Country | US
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Telephone | 316-263-0296
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Fax | 316-684-3326
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 18133
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License Number State | KS
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