Organization
EMERGENCY SERVICES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY MARTIN (GROUP MANAGER)
(316) 962-2239
Entity
Organization
Contact information
Practice address
550 N HILLSIDE ST, WICHITA, KS 67214-4910
(316) 962-2239
Mailing address
PO BOX 548, WICHITA, KS 67201-0548
(316) 962-2239
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016771
BLUE CROSS BLUE SHIELD
KS
Enumeration date
05/10/2006
Last updated
01/16/2008
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