MEDICARE: PREFERRED MEDICAL ASSOCIATES

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	2085U0001X	Diagnostic Ultrasound Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1861673907
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED MEDICAL ASSOCIATES

Provider Business Mailing Address
First Line	:	PO BOX 764
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67201-0764
Country	:	US
Telephone Number	:	316-268-8123
Fax Number	:	316-291-7716

Provider Business Practice Location Address
First Line	:	1900 N AMIDON AVE
Second Line	:	STE 100
City	:	WICHITA
State	:	KS
Zip	:	67203-2140
Country	:	US
Telephone Number	:	316-687-1555
Fax Number	:	316-291-4988

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EDWARD J HETT
Credential	:	MD
Telephone Number	:	316-268-8080

Provider Enumeration Date	:	11/16/2007
Last Update Date	:	03/19/2012

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Directions to “PREFERRED MEDICAL ASSOCIATES ” Practice Location

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