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Organization
MID-KANSAS WOUND SPECIALIST P A
Active
Organization
MID-KANSAS WOUND SPECIALIST P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN GOODEN (OWNER)
(972) 786-4990
Entity
Organization
Contact information
Practice address
10346 E STONEGATE LN STE 100, WICHITA, KS 67206-2054
(316) 910-0024
(316) 910-0023
Mailing address
PO BOX 801660, KANSAS CITY, MO 64180-0001
(800) 700-0278
Taxonomy
Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
—
NULL
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
—
—
Other
Enumeration date
06/30/2006
Last updated
10/19/2023
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