Organization
PODIATRY CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY K MCNEIL D.P.M. (PRESIDENT)
(316) 685-3801
Entity
Organization
Contact information
Practice address
400 N WOODLAWN ST STE 211, WICHITA, KS 67208-4332
(316) 685-3801
(316) 685-6901
Mailing address
400 N WOODLAWN ST STE 211, WICHITA, KS 67208-4332
(316) 685-3801
(316) 685-6901
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
12-00142
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100094390B
—
KS
01
—
480029429
RRMEDICARE
KS
Enumeration date
07/13/2007
Last updated
12/13/2013
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