Individual
DR. MARY LEONA HEAVENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1010 N KANSAS ST, WICHITA, KS 67214-3124
(316) 293-2665
Mailing address
1700 S MAIN ST, FORT SCOTT, KS 66701-3456
(620) 215-0436
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
94-10913
KS
Other
Enumeration date
05/22/2022
Last updated
03/02/2026
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