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Individual

ALAN J MCCORMICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
5231 E CENTRAL AVE, SUITE D, WICHITA, KS 67208-4195
(316) 683-6870
(316) 683-6873
Mailing address
1851 N WEBB RD, WICHITA, KS 67206-3413
(316) 858-3831
(316) 858-3830

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1574
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100371210A
KS
01
12149431
MULTIPLAN
KS
01
12973
PHS
KS
01
17016
COVENTRY
KS
01
202927
HPK
KS
01
650762
BCBS
KS
Enumeration date
06/17/2006
Last updated
01/20/2017
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