Individual
PATRICIA PETRAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
Mailing address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25259
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100191130D
—
KS
01
—
102871
BCBS
KS
01
—
167528
COVENTRY
KS
01
—
301817
HPK
KS
01
—
4635
PHS
KS
Enumeration date
06/18/2006
Last updated
07/28/2015
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