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Individual

MICHAEL HEANEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8080 E CENTRAL AVE, STE 250, WICHITA, KS 67206-2361
(316) 686-7327
(316) 686-1557
Mailing address
8080 E CENTRAL AVE, STE 250, WICHITA, KS 67206-2361
(316) 686-7327
(316) 686-1557

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036140498
IL
207L00000X
Anesthesiology Physician
Primary
04-24571
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100164020B
KS
01
214881
MULTISPECIALTY GROUP PTAN
IL
Enumeration date
08/12/2005
Last updated
06/04/2021
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