Individual
MANUEL ALFONSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1947 N FOUNDERS ST, WICHITA, KS 67206-3548
(316) 613-4931
(316) 613-4937
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9102
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
15093
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000272F
BCBS
KS
01
—
12149494
MULTIPLAN
KS
01
—
16
PHS
KS
01
—
16878
COVENTRY
KS
01
—
200101
HPK
KS
Enumeration date
08/31/2006
Last updated
07/08/2007
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