Organization
HEARTLAND SURGERY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHIVUKULA SUBBARAO MD (OWNER)
(316) 683-3600
Entity
Organization
Contact information
Practice address
1431 S BLUFFVIEW DR, STE #209, WICHITA, KS 67218-3039
(316) 683-3600
(316) 683-3635
Mailing address
1431 S BLUFFVIEW DR, STE #209, WICHITA, KS 67218-3039
(316) 683-3600
(316) 683-3635
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110926
BCBS OF KS
KS
Enumeration date
08/28/2007
Last updated
08/28/2007
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