Jack Staddon, MD, PHD | |
3243 E Murdock St Ste 510, Wichita, KS 67208-3007 | |
(316) 962-3928 | |
(316) 962-3930 |
Full Name | Jack Staddon |
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Gender | Male |
Speciality | Pediatrics - Pediatric Hematology-oncology |
Location | 3243 E Murdock St Ste 510, Wichita, Kansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1952500415 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0207X | Pediatrics - Pediatric Hematology-oncology | 04-45815 (Kansas) | Primary |
Entity Name | University Of Kansas School Of Medicine Wichita Medical Practice Assoc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1639143712 PECOS PAC ID: 3577464841 Enrollment ID: O20040119000674 |
Entity Name | Wesley Physicians Medical Specialties Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1699069732 PECOS PAC ID: 1355509886 Enrollment ID: O20120229000737 |
Mailing Address | Practice Location Address |
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Jack Staddon, MD, PHD 3243 E Murdock St Ste 510, Wichita, KS 67208-3007 Ph: (316) 962-3928 | Jack Staddon, MD, PHD 3243 E Murdock St Ste 510, Wichita, KS 67208-3007 Ph: (316) 962-3928 |
Patrick Bowen, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1010 N. Kansas, Wcgme, Wichita, KS 67214 Phone: 316-962-3030 | |
Dr. Cindy Daugherty, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 620 N Carriage Pkwy, Wichita, KS 67208 Phone: 316-962-3100 Fax: 316-962-3132 | |
Deborah Anne Kroeker Alliston, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 620 N Carriage Pkwy, Wichita, KS 67208 Phone: 316-962-3100 Fax: 316-962-3132 | |
Justin Alexander Mills, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1010 N Kansas St, Wichita, KS 67214 Phone: 316-962-3030 | |
Luke O Nichols, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 9211 E 21st St N, Wichita, KS 67206 Phone: 316-609-4400 Fax: 316-634-4040 | |
Kay Hocutt, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 9211 E 21st St N, Wichita, KS 67206 Phone: 316-609-4400 Fax: 316-634-4040 | |
Grace Nehme, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1010 N Kansas St, Wichita, KS 67214 Phone: 316-293-2665 |