Individual
MR. RICK PUSTKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
2610 N WOODLAWN BLVD, WICHITA, KS 67220-2729
(316) 858-2601
(316) 858-2793
Mailing address
2610 N WOODLAWN BLVD, WICHITA, KS 67220-2729
(316) 858-2601
(316) 858-2793
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1500950
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200260850A
—
KS
Enumeration date
03/27/2006
Last updated
04/28/2010
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