Individual
CHARLES D PENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1947 FOUNDERS ST, WICHITA, KS 67206-3548
(316) 689-9175
(316) 613-4704
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9102
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
14229
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001521
BCBS
KS
01
—
12149391
MULTIPLAN
KS
01
—
16915
COVENTRY
KS
01
—
200142
HPK
KS
01
—
722
PHS
KS
Enumeration date
06/27/2006
Last updated
07/13/2007
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