Organization
ICT EYE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER K BURGOYNE M.D. (OWNER)
(316) 841-2805
Entity
Organization
Contact information
Practice address
9300 E 29TH ST N STE 315, WICHITA, KS 67226-2184
(316) 425-0445
(316) 425-0460
Mailing address
PO BOX 743, WICHITA, KS 67201-0743
(316) 425-0445
(316) 425-0460
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
04-29078
KS
Other
Enumeration date
01/05/2015
Last updated
01/12/2024
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