Individual
DR. LYLE HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
720 W CENTRAL AVE, EL DORADO, KS 67042-2112
(316) 321-8780
(316) 321-8723
Mailing address
PO BOX 781378, WICHITA, KS 67278-1378
(316) 321-8780
(316) 321-8723
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
0441126
KS
2085R0001X
Radiation Oncology Physician
7666
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201205230A
—
KS
01
—
EA5581
RADIATION ONCOLOGY
KS
Enumeration date
11/15/2006
Last updated
03/15/2021
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