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Organization

CENTRAL PLAINS EYE MDS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN CHRIS PEDERSEN JR. (OFFICE MANAGER)
(316) 712-4970
Entity
Organization

Contact information

Practice address
7717 E 29TH ST N STE 100, WICHITA, KS 67226-3444
(316) 712-4970
(316) 712-4987
Mailing address
7717 E 29TH ST N, SUITE 100, WICHITA, KS 67226-3443
(316) 712-4970
(316) 712-4987

Taxonomy

Speciality
Code
Description
License number
State
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
207WX0107X
Retina Specialist (Ophthalmology) Physician
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary

Other

Enumeration date
07/24/2008
Last updated
09/25/2019
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