Organization
WICHITA BONE & JOINT CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL P. ESTIVO D.O. (OWNER)
(316) 945-9915
Entity
Organization
Contact information
Practice address
6634 W CENTRAL AVE, SUITE 150, WICHITA, KS 67212-3315
(316) 945-9915
(316) 612-1910
Mailing address
PO BOX 780129, WICHITA, KS 67278-0129
(316) 945-9915
(316) 612-1910
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110921
BLUE CROSS BLUE SHIELD
KS
05
—
200003070A
—
KS
Enumeration date
03/19/2007
Last updated
06/19/2009
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