Organization
WICHITA OB-GYN ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRISTA LONG CPC (PRACTICE ADMINISTRATOR)
(316) 685-0559
Entity
Organization
Contact information
Practice address
551 N HILLSIDE ST, STE 510, WICHITA, KS 67214-4923
(316) 685-0559
(316) 685-0455
Mailing address
PO BOX 3951, WICHITA, KS 67201-3951
(316) 685-0559
(316) 685-0455
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
225100000X
Physical Therapist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200741040A
—
KS
Enumeration date
07/05/2006
Last updated
07/01/2021
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