Individual
MICHAEL R. EASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10100 E SHANNON WOODS ST, SUITE 100, WICHITA, KS 67226-4104
(316) 219-8299
(316) 219-5899
Mailing address
10100 E SHANNON WOODS ST, SUITE 100, WICHITA, KS 67226-4104
(316) 219-8299
(316) 219-5899
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
15-00207
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042939
BLUE SHIELD
KS
05
—
100424670B
—
KS
01
—
14012
PREFERRED HEALTH SYSTEMS
KS
01
—
502180
FIRST GUARD
KS
01
—
970028115
R. R. MEDICARE
—
Enumeration date
06/02/2006
Last updated
04/06/2017
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