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Individual

MARTIN DE LA PRESA POTHIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1851 N WEBB RD, WICHITA, KS 67206-3413
(316) 636-2010
Mailing address
1851 N WEBB RD, WICHITA, KS 67206-3413
(316) 636-2010

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
04-44602
KS
207W00000X
Ophthalmology Physician
Primary
35138908
OH
207W00000X
Ophthalmology Physician
53669
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201329490A
KS
Enumeration date
03/20/2016
Last updated
06/03/2021
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