Organization
EYE SURGERY CENTER OF WICHITA, LLC
Active
Other names
Team Vision Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFRREY E. SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
6100 E CENTRAL AVE STE 5, WICHITA, KS 67208-4237
(316) 681-2020
(316) 684-4939
Mailing address
1A BURTON HILLS BLVD, NASHVILLE, TN 37215-6187
(615) 665-1283
(615) 234-1720
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
SO87004
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100343550A
—
KS
01
—
1181
PPK & PHS
KS
01
—
490004218
RAILROAD MEDICARE
KS
Enumeration date
06/18/2006
Last updated
03/30/2022
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