Individual
DR. JOHN MARTIN LASAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9350 E CENTRAL AVE, WICHITA, KS 67206-2555
(316) 686-6608
(316) 686-3624
Mailing address
9350 E CENTRAL AVE, WICHITA, KS 67206-4999
(316) 686-6608
(316) 686-3624
Taxonomy
Speciality
Code
Description
License number
State
207YX0901X
Otology & Neurotology Physician
Primary
04-29030
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040016259
RAILROAD MEDICARE
KS
05
—
100396360A
—
KS
01
—
100888
BLUE CROSS
KS
01
—
412510
FIRSTGAURD
KS
01
—
48118525067206A003
CHAMPUS
KS
01
—
9633
PHS-PPK
KS
Enumeration date
06/01/2005
Last updated
11/23/2022
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