Individual
PATRICIA G WYATT-HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3233 E 2ND ST N, WICHITA, KS 67208-3202
(316) 683-6766
(316) 616-0073
Mailing address
3233 E 2ND ST N, WICHITA, KS 67208-3202
(316) 683-6766
(316) 616-0073
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19715
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047339
BCBS ID #
KS
05
—
100169900A
—
KS
01
—
1045
PPK ID #
KS
Enumeration date
02/15/2006
Last updated
03/11/2011
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