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Individual

DR. RANDALL LAIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9828 E SHANNON WOODS CIR # 100, WICHITA, KS 67226-4100
(316) 631-1600
(316) 631-1639
Mailing address
9828 E SHANNON WOODS CIR # 100, WICHITA, KS 67226-4100
(316) 631-1600
(316) 631-1617

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
04-27074
KS
207XX0801X
Orthopaedic Trauma Physician
Primary
04-27074
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
041674507
TX
05
047164506
TX
05
100199000A
OK
05
100290930A
KS
01
110705040
MEDICARE
KS
01
1144258443
BCBS
KS
01
8BR084
BCBS
TX
01
8S4335
BCBS
TX
05
9000171587
CO
Enumeration date
06/28/2006
Last updated
03/17/2026
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