# COSMETIC & RECONSTRUCTIVE SURGERY CENTER, PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** COSMETIC & RECONSTRUCTIVE SURGERY CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659327245
- **Authorized official:** DR. MATTHEW HARRIS CONRAD M.D. (PHYSICIAN)
- **Authorized official phone:** (316) 681-2227

## Contact information

- **Practice address:** 1700 N WATERFRONT PKWY, BUILDING 200, WICHITA, KS 67206-6614
- **Practice address phone:** (316) 681-2227
- **Practice address fax:** (316) 684-5250
- **Mailing address:** 1700 N WATERFRONT PKWY, BUILDING 200, WICHITA, KS 67206-6614
- **Mailing address phone:** (316) 681-2227
- **Mailing address fax:** (316) 684-5250

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 0429556 | KS | Yes |

## Other

- **Enumeration date:** 05/25/2006
- **Last updated:** 12/11/2014