Individual
THOMAS ALLEN WOLTJER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
530 N LORRAINE AVE, WICHITA, KS 67214-4837
(316) 683-5611
(316) 683-0294
Mailing address
530 N LORRAINE AVE, WICHITA, KS 67214-4837
(316) 683-5611
(316) 683-0294
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
05-42080
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201252990A
—
KS
Enumeration date
05/19/2013
Last updated
11/07/2024
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