Individual
SHANNON L LOECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 N MINNEAPOLIS ST, WICHITA, KS 67214-3127
(316) 293-2647
(855) 476-0305
Mailing address
1010 N KANSAS ST, WICHITA, KS 67214-3124
(316) 293-2665
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
04-43063
KS
2084P0800X
Psychiatry Physician
94-08890
KS
2255A2300X
Athletic Trainer
000164
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30004650390002
—
KS
Enumeration date
02/27/2007
Last updated
06/19/2023
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