Organization
R LAMONT BLOOM MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI L BLOOM RN (SECRETARY/OFFICE MANAGER)
(316) 265-0705
Entity
Organization
Contact information
Practice address
406 E CENTRAL AVE, WICHITA, KS 67202-1058
(316) 265-0705
(316) 265-0785
Mailing address
406 E CENTRAL AVE, WICHITA, KS 67202-1058
(316) 265-0705
(316) 265-0785
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
KS
Other
Enumeration date
07/25/2016
Last updated
10/24/2018
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