Individual
DR. RUSSELL LARRY BEAMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
818 N EMPORIA ST, SUITE 200, WICHITA, KS 67214-3729
(316) 263-0296
(316) 263-9523
Mailing address
551 N HILLSIDE ST STE 201, WICHITA, KS 67214-4923
(316) 263-0296
(316) 263-9523
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0418698
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100167490A
—
KS
Enumeration date
07/07/2005
Last updated
07/30/2021
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