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Individual

JOHN L KREADY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9211 E 21ST ST N, WICHITA, KS 67206-2968
(316) 609-4511
(316) 636-4076
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9102

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18736
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
024372
BCBS
KS
01
100356
HPK
KS
01
12149369
MULTIPLAN
KS
01
16851
COVENTRY
KS
01
502
PHS
KS
Enumeration date
07/03/2006
Last updated
07/13/2007
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