Organization
FREESTATE HEALTH PLLC
Active
Organization
FREESTATE HEALTH PLLC
Active
Other names
FreeState
Organization subpart
No
Provider details
NPI number
Authorized official
ELISHA YAGHMAI MD, MPH&TM (PRESIDENT)
(888) 505-1776
Entity
Organization
Contact information
Practice address
4723 E DOUGLAS AVE, WICHITA, KS 67218-1012
(888) 505-1776
(888) 505-1776
Mailing address
4723 E DOUGLAS AVE, WICHITA, KS 67218-1012
(888) 505-1776
(888) 505-1776
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-33447
KS
208000000X
Pediatrics Physician
04-33447
KS
261QM1300X
Multi-Specialty Clinic/Center
Primary
04-33447
KS
Other
Enumeration date
04/18/2017
Last updated
04/18/2017
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