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General NPI Number Information
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NPI Number | 1902912686
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Entity Type | Organization
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Legal Business Name | RIORDAN CLINIC, INC
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 01/12/2011
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Provider Practice Location Address
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Address Line | 3100 N HILLSIDE AVE
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City | WICHITA
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State | KS
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Zip | 67219-3904
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Country | US
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Telephone | 316-682-3100
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Fax | 316-618-8537
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Provider Business Mailing Address
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Address Line | 3100 N HILLSIDE AVE
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City | WICHITA
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State | KS
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Zip | 67219-3904
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Country | US
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Telephone | 316-682-3100
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Fax | 316-618-8537
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER/BOARD MEMBER
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Name | RONALD E HUNNINGHAKE
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Credential | MD
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Telephone | 316-682-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104594
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0430080
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 0432003
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0417711
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License Number State | KS
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