# MID-KANSAS WOUND SPECIALIST P A

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326076977
- **Authorized official:** JUSTIN GOODEN (OWNER)
- **Authorized official phone:** (972) 786-4990

## Contact information

- **Practice address:** 10346 E STONEGATE LN STE 100, WICHITA, KS 67206-2054
- **Practice address phone:** (316) 910-0024
- **Practice address fax:** (316) 910-0023
- **Mailing address:** PO BOX 801660, KANSAS CITY, MO 64180-0001
- **Mailing address phone:** (800) 700-0278

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | NULL | Yes |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/30/2006
- **Last updated:** 10/19/2023