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Organization
KANSAS JOINT & SPINE INSTITUTE
Active
Organization
KANSAS JOINT & SPINE INSTITUTE
Active
Other names
Kansas Joint and Spine Pain Management Center
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE BROCK-BAKER (CEO)
(316) 858-1900
Entity
Organization
Contact information
Practice address
10100 SHANNON WOODS ST, WICHITA, KS 67226-4103
(316) 858-1900
(316) 858-1905
Mailing address
10100 SHANNON WOODS ST, WICHITA, KS 67226-4103
(316) 858-1900
(316) 858-1905
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KA2539
MEDICARE PTAN
KS
Enumeration date
06/08/2010
Last updated
11/16/2012
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