Organization
DOERKSEN & ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL L DOERKSEN O.D. (OWNER)
(316) 721-3377
Entity
Organization
Contact information
Practice address
7570 W 21ST ST N, BLDG. 1002, WICHITA, KS 67205-1734
(316) 721-3377
(316) 721-6077
Mailing address
7570 W 21ST ST N, BLDG. 1002, WICHITA, KS 67205-1734
(316) 721-3377
(316) 721-6077
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1324
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
049835
BLUE CROSS
KS
01
—
3712
PREFERRED HEALTH
—
05
—
462231
—
KS
Enumeration date
03/29/2007
Last updated
06/21/2018
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