Individual
GREGGORY JESSE VANSICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3500 SW 6TH AVE, TOPEKA, KS 66606-2806
(785) 235-0335
(785) 235-0368
Mailing address
3500 SW 6TH AVE, TOPEKA, KS 66606-2806
(785) 235-0335
(785) 235-0368
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
04-18965
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018929
BLUE CROSS BLUE SHIELD
KS
05
—
100083540A
—
KS
Enumeration date
08/12/2006
Last updated
07/09/2009
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