Organization
EA2, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUSTAQUIO DE OCAMPO ABAY II MD, FACS (PRESIDENT)
(316) 425-0005
Entity
Organization
Contact information
Practice address
3305 E DOUGLAS AVE, SUITE 101, WICHITA, KS 67218-1036
(316) 644-3412
Mailing address
3305 E DOUGLAS AVE, SUITE 101, WICHITA, KS 67218-1036
(316) 425-0005
(316) 425-0007
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
04-21083
KS
Other
Enumeration date
05/17/2011
Last updated
03/29/2012
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