Organization
CYPRESS HEART, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER WILLIAMS EVANS MD (PRESIDENT)
(316) 858-9000
Entity
Organization
Contact information
Practice address
9300 E 29TH ST N, SUITE 310, WICHITA, KS 67226-2182
(316) 858-9000
(316) 858-9005
Mailing address
PO BOX 25943, OKLAHOMA CITY, OK 73125-0943
(316) 858-9000
(316) 858-9005
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
2080P0202X
Pediatric Cardiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100420380A
—
KS
05
—
100723470A
—
OK
01
—
300522249
MEDICARE
OK
01
—
CG1068
RAILROAD MEDICARE
—
Enumeration date
04/28/2006
Last updated
09/07/2010
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