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Organization

SURGICAL SPECIALISTS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN P SMITH DO (MANAGING PARTNER)
(316) 945-7309
Entity
Organization

Contact information

Practice address
4013 N RIDGE RD, STE 210, WICHITA, KS 67205-8860
(316) 945-7309
(316) 945-9131
Mailing address
PO BOX 905, WICHITA, KS 67201-0905
(316) 945-7309
(316) 945-9131

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100217610A
KS
Enumeration date
03/15/2006
Last updated
05/19/2021
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