Individual
ROBERT LEROY ULLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8200 W CENTRAL AVE STE 1, WICHITA, KS 67212-3661
(316) 491-6340
Mailing address
8200 W CENTRAL AVE STE 1, WICHITA, KS 67212-3661
(316) 721-4544
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-34369
KS
Other
Enumeration date
07/01/2009
Last updated
10/27/2022
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