Organization
CARDIO-KIDNEY VASCULAR CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA SMITH LRT (ADMINISTRATOR)
(316) 402-0441
Entity
Organization
Contact information
Practice address
3161 N WEBB RD STE 220, WICHITA, KS 67226
(316) 402-0440
(316) 402-0451
Mailing address
3161 N WEBB RD STE 220, WICHITA, KS 67226
(316) 402-0440
(316) 402-0451
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207RN0300X
Nephrology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
07/19/2021
Last updated
08/03/2023
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