MEDICARE: DR. ORVILLE R WETZEL MD

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
1	207L00000X	Anesthesiology Physician	04-24624	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	050089299	OTHER	KS	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	102268	OTHER	KS	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689651960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ORVILLE R WETZEL MD

Provider Business Mailing Address
First Line	:	PO BOX 47662
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67201-7662
Country	:	US
Telephone Number	:	316-685-3698
Fax Number	:	316-652-0340

Provider Business Practice Location Address
First Line	:	6001 SW 6TH AVE
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66615-1011
Country	:	US
Telephone Number	:	316-685-3698
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	10/28/2013

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