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Organization

ENDOSCOPIC SERVICES, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JACE WARD HYDER M.D. (CEO)
(316) 687-0234
Entity
Organization

Contact information

Practice address
1431 BLUFFVIEW ST STE 215, WICHITA, KS 67218-3039
(316) 687-0234
(316) 687-0360
Mailing address
1431 BLUFFVIEW ST STE 215, WICHITA, KS 67218-3039
(316) 687-0234
(316) 687-0360

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
S-087-008
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
015223
BCBS PROVIDER #
KS
05
100216580A
KS
Enumeration date
06/24/2006
Last updated
08/22/2011
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