Organization
J. W, LEISY M.D.P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERALD W LEISY M.D. P.A. (PRESIDENT)
(316) 681-2937
Entity
Organization
Contact information
Practice address
3310 EAST DOUGLAS #101, WICHITA, KS 67208
(316) 681-2937
(316) 681-1262
Mailing address
3310 EAST DOUGLAS #101, WICHITA, KS 67208
(316) 681-2937
(316) 681-1262
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
14574
KS
Other
Enumeration date
05/16/2012
Last updated
09/19/2012
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