|
| |
|
550 N Hillside St Wichita KS 67214-4910 | |
| (316) 962-2030 | |
| (316) 962-3056 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 550 N Hillside St, Wichita, Kansas |
| Authorized Official Name and Position | Nicole Castleberry (CFO) |
| Authorized Official Contact | 3169622055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 47490 Wichita KS 67201-7490 Ph: (316) 962-3150 | 550 N Hillside St Wichita KS 67214-4910 Ph: (316) 962-2030 |
| NPI Number | 1588632145 |
|---|---|
| Provider Enumeration Date | 03/09/2006 |
| Last Update Date | 10/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588632145 | NPI | - | NPPES |
| 100327110I | Medicaid | KS | |
| 110784 | Other | KS | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
Form Associates, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 E Douglas Ave Fl 2, Wichita, KS 67202 Phone: 617-505-1520 | |
Primary Care Associates, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7111 E 21st St N Ste A, Wichita, KS 67206 Phone: 316-684-2851 | |
Substance Abuse At Hunter Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2318 E Central Ave, Wichita, KS 67214 Phone: 316-262-3611 Fax: 316-262-0741 | |
Robert A Sweet Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3122 N Cypress Dr, Suite 100, Wichita, KS 67226 Phone: 316-260-4747 | |
World Impact, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3701 E 13th St N, #400, Wichita, KS 67208 Phone: 316-682-1880 |