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NPI Code Detail

MEDICARE: PATRICIA G WYATT-HARRIS M.D.

MEDICARE: PATRICIA G WYATT-HARRIS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist19715KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2047339OTHERKSBCBS ID #
31045OTHERKSPPK ID #

General Provider Information

NPI Number : 1255305140
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA G WYATT-HARRIS M.D.
Provider Business Mailing Address
First Line : 3233 E 2ND ST N
Second Line :
City : WICHITA
State : KS
Zip : 67208-3202
Country : US
Telephone Number : 316-683-6766
Fax Number : 316-616-0073
Provider Business Practice Location Address
First Line : 3233 E 2ND ST N
Second Line :
City : WICHITA
State : KS
Zip : 67208-3202
Country : US
Telephone Number : 316-683-6766
Fax Number : 316-616-0073
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 03/11/2011

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