Organization
WICHITA PAIN ASSOCIATES PA
Active
Other names
Wichita Pain Associates Cosmetic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY DUANE FENN D.C. (PRESIDENT)
(316) 258-5955
Entity
Organization
Contact information
Practice address
2548 N MAIZE CT, SUITE 104, WICHITA, KS 67205-7347
(316) 722-4247
(316) 722-4287
Mailing address
2544 N MAIZE CT, SUITE 100, WICHITA, KS 67205-7324
(316) 722-4247
(316) 722-4287
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
04-23263
KS
207Q00000X
Family Medicine Physician
Primary
0424741
KS
207Q00000X
Family Medicine Physician
0430440
KS
363L00000X
Nurse Practitioner
44143
KS
Other
Enumeration date
11/18/2011
Last updated
12/28/2012
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