Individual
DR. ETHAN PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
707 N EMPORIA ST, WICHITA, KS 67214-3707
(316) 858-3499
Mailing address
1010 N KANSAS ST, WICHITA, KS 67214-3124
(316) 293-2665
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
94-11990
KS
Other
Enumeration date
06/22/2024
Last updated
06/27/2024
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