Individual
SANDY R DILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
929 N SAINT FRANCIS ST, WICHITA, KS 67214-3821
(800) 374-5326
(800) 374-7656
Mailing address
PO BOX 2897, WICHITA, KS 67201-2897
(800) 374-5326
(800) 374-7656
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0422335
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050032602
RR MEDICARE GROUP CQ2302
—
05
—
100137650C
—
KS
01
—
106160
BCBS OF KS
KS
Enumeration date
05/18/2006
Last updated
03/20/2008
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