Individual
ALAN J FEAREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
818 N CARRIAGE PKWY, WICHITA, KS 67208-4511
(316) 651-2252
(316) 651-2314
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9102
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18715
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002621
MEDICARE
—
05
—
100202810A
—
KS
Enumeration date
06/18/2006
Last updated
03/02/2017
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