Organization
LIBERTAS CORP.
Active
Organization
LIBERTAS CORP.
Active
Other names
Freestate Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELISHA YAGHMAI MD (PRESIDENT)
(800) 924-8140
Entity
Organization
Contact information
Practice address
4723 E DOUGLAS AVE, WICHITA, KS 67218-1012
(800) 924-8140
(800) 924-8140
Mailing address
4723 E DOUGLAS AVE, WICHITA, KS 67218-1012
(800) 924-8140
(800) 924-8140
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
04-33447
KS
207R00000X
Internal Medicine Physician
Primary
04-33447
KS
208000000X
Pediatrics Physician
04-33447
KS
208M00000X
Hospitalist Physician
04-33447
KS
Other
Enumeration date
10/24/2016
Last updated
12/29/2016
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