Organization
KANSAS LONG TERM CARE PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGIA DENNE (MANAGER)
(316) 269-5000
Entity
Organization
Contact information
Practice address
1315 N WEST ST, WICHITA, KS 67203-1382
(316) 943-1295
Mailing address
155 N MARKET ST, SUITE 950, WICHITA, KS 67202-1816
(316) 269-5000
(316) 269-0404
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111216
BCBS
KS
01
—
DE4553
RAIL ROAD MEDICARE
KS
Enumeration date
06/25/2006
Last updated
11/20/2007
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