Organization
TALLGRASS GENERAL, VASCULAR & THORACIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA VANDERWIEDE (OFFICE MANAGER)
(785) 232-0444
Entity
Organization
Contact information
Practice address
6001 SW 6TH AVE, SUITE 220, TOPEKA, KS 66615-1011
(785) 232-0444
(785) 232-1562
Mailing address
6001 SW 6TH AVE, SUITE 220, TOPEKA, KS 66615-1011
(785) 232-0444
(785) 232-1562
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN9836
RAILROAD MEDICARE
KS
Enumeration date
05/30/2006
Last updated
04/07/2008
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