Individual
TAYLOR RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
707 N EMPORIA ST, WICHITA, KS 67214-3707
(316) 858-3460
Mailing address
707 N EMPORIA ST, WICHITA, KS 67214-3707
(316) 858-3460
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-46665
KS
Other
Enumeration date
05/21/2019
Last updated
06/23/2025
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