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Organization
WICHITA PAIN ASSOCIATES PA
Active
Organization
WICHITA PAIN ASSOCIATES PA
Active
Other names
Wichita Pain Associates Cosmetic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY DUANE FENN D.C. (PRESIDENT)
(316) 258-5955
Entity
Organization
Contact information
Practice address
2548 N MAIZE CT, SUITE 104, WICHITA, KS 67205-7347
(316) 722-4247
(316) 722-4287
Mailing address
2544 N MAIZE CT, SUITE 100, WICHITA, KS 67205-7324
(316) 722-4247
(316) 722-4287
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
04-23263
KS
207Q00000X
Family Medicine Physician
Primary
0424741
KS
207Q00000X
Family Medicine Physician
0430440
KS
363L00000X
Nurse Practitioner
44143
KS
Other
Enumeration date
11/18/2011
Last updated
12/28/2012
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