Individual
TONY VAN VU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
7550 W VILLAGE CIR, STE. 1, WICHITA, KS 67205-9363
(316) 838-2020
(316) 838-7574
Mailing address
7550 W VILLAGE CIR, STE. 1, WICHITA, KS 67205-9363
(316) 838-2020
(316) 838-7574
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-00891
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042990
BLUE CROSS BLUE SHIELD
KS
05
—
200000900A
—
KS
Enumeration date
03/19/2007
Last updated
07/29/2013
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