Individual
LI JIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1010 N. KANSAS, WCGME, WICHITA, KS 67214
(316) 962-3030
Mailing address
1010 N. KANSAS, WCGME, WICHITA, KS 67214
(316) 962-3030
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
04-38961
KS
207P00000X
Emergency Medicine Physician
2020010409
MO
207R00000X
Internal Medicine Physician
9407949
KS
Other
Enumeration date
07/03/2012
Last updated
01/12/2021
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