Organization
WESLEY MEDICAL CENTER LLC
Active
Other names
Wesley Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE CASTLEBERRY (CFO)
(316) 962-2055
Entity
Organization
Contact information
Practice address
850 N HILLSIDE ST, WICHITA, KS 67214-4914
(316) 962-3070
(316) 962-3136
Mailing address
PO BOX 47490, WICHITA, KS 67201-7490
(316) 962-3150
(316) 962-7334
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100327110E
—
KS
01
—
110458
BLUE CROSS BLUE SHIELD
KS
Enumeration date
03/08/2006
Last updated
10/20/2022
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