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General NPI Number Information
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NPI Number | 1861673907
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Entity Type | Organization
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Legal Business Name | PREFERRED MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 11/16/2007
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Last Update Date | 03/19/2012
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Provider Practice Location Address
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Address Line | 1900 N AMIDON AVE STE 100
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City | WICHITA
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State | KS
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Zip | 67203-2140
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Country | US
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Telephone | 316-687-1555
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Fax | 316-291-4988
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Provider Business Mailing Address
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Address Line | PO BOX 764
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City | WICHITA
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State | KS
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Zip | 67201-0764
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Country | US
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Telephone | 316-268-8123
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Fax | 316-291-7716
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD J HETT
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Credential | MD
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Telephone | 316-268-8080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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