Individual
DR. JEFFREY A BOOMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 N TOPEKA, WICHITA, KS 67214-2810
(316) 263-6273
(316) 263-5568
Mailing address
1100 N TOPEKA, WICHITA, KS 67214-2810
(316) 263-6273
(316) 263-5568
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
04-31763
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200421070C
—
KS
Enumeration date
11/09/2005
Last updated
12/23/2011
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