Organization
VITREO-RETINAL CONSULTANTS & SURGEONS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY A MAREK (PRACTICE ADMINISTRATOR)
(316) 683-3108
Entity
Organization
Contact information
Practice address
530 N LORRAINE ST, WICHITA, KS 67214-4837
(316) 683-5611
(316) 683-0294
Mailing address
530 N LORRAINE ST, WICHITA, KS 67214-4837
(316) 683-5611
(316) 683-0294
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
KS
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Enumeration date
07/27/2006
Last updated
07/11/2024
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