Individual
DR. LOWELL D EBERSOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3311 E MURDOCK ST, WICHITA, KS 67208-3054
(316) 689-9379
(316) 689-9118
Mailing address
3311 E MURDOCK ST, WICHITA, KS 67208-3054
(316) 689-9379
(316) 689-9118
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0529885
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003719239
MEDICARE
—
05
—
100427230A
—
KS
Enumeration date
06/28/2006
Last updated
05/08/2014
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