Organization
WICHITA FAMILY VISION CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT C NELSON O.D. (OWNER)
(316) 722-1001
Entity
Organization
Contact information
Practice address
437 N. TYLER, WICHITA, KS 67212
(316) 722-1001
(316) 722-1073
Mailing address
437 N. TYLER, WICHITA, KS 67212
(316) 722-1001
(316) 722-1073
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017146
BLUE CROSS
KS
Enumeration date
09/29/2006
Last updated
07/28/2020
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