Organization
KANSAS VEIN CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL H. CHEATUM M.D. (PRESIDENT)
(316) 634-6622
Entity
Organization
Contact information
Practice address
10096 E 13TH ST N, SUITE 144, WICHITA, KS 67206-2645
(316) 634-6622
(316) 630-9461
Mailing address
10333 E 21ST ST N, SUITE 401, WICHITA, KS 67206-3543
(316) 636-9580
(316) 630-9461
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
BCBS
KS
Enumeration date
06/29/2007
Last updated
08/22/2020
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