Individual
DR. MARISA J FLYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3600 E HARRY ST, WICHITA, KS 67218-3713
(316) 685-1111
Mailing address
6120 SHADYBROOK ST, WICHITA, KS 67208-1862
(316) 269-5000
(316) 269-0404
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
0430696
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105245
BCBS
KS
05
—
200372690A
—
KS
01
—
P00308265
RAIL ROAD MEDICARE
—
Enumeration date
07/03/2006
Last updated
09/14/2009
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