Organization
WALNUT VALLEY IMAGING PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL ROSENQUIST MD (PRESIDENT)
(620) 441-5788
Entity
Organization
Contact information
Practice address
817 MAIN ST, WINFIELD, KS 67156-2834
(620) 441-5788
Mailing address
PO BOX 47309, WICHITA, KS 67201-7309
(316) 685-8428
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111117
BCBS
KS
05
—
200046910A
—
OK
05
—
200385950A
—
KS
01
—
201910946001
BCBS
OK
05
—
504467606
—
MO
Enumeration date
03/29/2006
Last updated
05/06/2008
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