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Organization

W H WHITESIDE INC

Active
Other names
College Hill Family & Pediatric Specialty Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WILLIAM HOWARD WHITESIDE MD (DOCTOR)
(316) 681-0086
Entity
Organization

Contact information

Practice address
5002 E CENTRAL AVE, WICHITA, KS 67208-4166
(316) 681-0086
(316) 681-8013
Mailing address
5002 E CENTRAL AVE, WICHITA, KS 67208-4166
(316) 681-0086
(316) 681-8013

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
103005
BCBS
01
663070
FIRST GUARD
Enumeration date
01/29/2007
Last updated
08/22/2020
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