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NPI Code Detail

MEDICARE: SAMUEL E HECK DO

MEDICARE: SAMUEL E HECK DO
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
1207Q00000XFamily Medicine Physician05-25560KS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1003719179OTHERMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346207370
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL E HECK DO
Provider Business Mailing Address
First Line : PO BOX 8035
Second Line :
City : WICHITA
State : KS
Zip : 67208-0035
Country : US
Telephone Number : 316-689-9135
Fax Number : 316-689-9667
Provider Business Practice Location Address
First Line : 14700 W SAINT TERESA ST STE 300
Second Line :
City : WICHITA
State : KS
Zip : 67235-9630
Country : US
Telephone Number : 316-274-0142
Fax Number : 316-719-1033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 09/26/2022

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