Organization
WICHITA RADIOLOGICAL GROUP PROF ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLYSA BRIGHAM (DIRECTOR REIMBURSEMENT OPERATIONS)
(316) 364-3661
Entity
Organization
Contact information
Practice address
551 N HILLSIDE ST, SUITE 320, WICHITA, KS 67214-4923
(316) 685-1367
(316) 685-1436
Mailing address
551 N HILLSIDE ST STE 320, WICHITA, KS 67214-4926
(316) 364-3661
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100094470A
—
KS
Enumeration date
06/25/2006
Last updated
05/31/2024
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