Organization
KANSAS IMAGING CONSULTANTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY BENNING MD (PRESIDENT)
(316) 689-5050
Entity
Organization
Contact information
Practice address
3600 E HARRY ST, WICHITA, KS 67218-3713
(316) 689-5050
(316) 689-6192
Mailing address
PO BOX 645, WICHITA, KS 67201-0645
(316) 689-5050
(316) 689-6192
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
KS
2085N0700X
Neuroradiology Physician
—
KS
2085N0904X
Nuclear Radiology Physician
—
KS
2085P0229X
Pediatric Radiology Physician
—
KS
2085R0202X
Diagnostic Radiology Physician
Primary
—
KS
2085R0203X
Therapeutic Radiology Physician
—
KS
2085R0204X
Vascular & Interventional Radiology Physician
—
KS
2085U0001X
Diagnostic Ultrasound Physician
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100270510A
—
KS
05
—
100723500A
—
OK
01
—
110297
BLUE CROSS BLUE SHIELD
KS
01
—
CC634
RR MEDICARE
KS
Enumeration date
03/01/2006
Last updated
10/13/2022
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