Organization
TALLGRASS IMAGING ASSOCIATES, L.L.C.
Active
Other names
Tallgrass Diagnostic Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY WAYNE WICKERSHAM (VP OF OPERATIONS)
(405) 418-2200
Entity
Organization
Contact information
Practice address
7111 E 21ST ST N, SUITE B, WICHITA, KS 67206-1078
(316) 925-4624
(316) 925-4625
Mailing address
7111 E 21ST ST N, SUITE B, WICHITA, KS 67206-1078
(316) 925-4624
(316) 925-4625
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
KS
Other
Enumeration date
10/26/2006
Last updated
08/22/2020
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