Individual
ROSALIE R FOCKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14700 W SAINT TERESA ST STE 300, WICHITA, KS 67235-9630
(316) 274-0142
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25432
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059201
MEDICARE
—
05
—
100280210A
—
KS
Enumeration date
06/23/2006
Last updated
11/08/2018
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