Individual
JENNIFER K BURGOYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9300 E 29TH ST N STE 315, WICHITA, KS 67226-2184
(316) 425-0445
(316) 425-0460
Mailing address
PO BOX 743, WICHITA, KS 67201-0743
(316) 425-0445
(316) 425-0460
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
29078
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100392290A
—
KS
01
—
100898
BCBS
KS
01
—
12149479
MULTIPLAN
KS
01
—
206313
HPK
KS
01
—
82259
COVENTRY
KS
01
—
9468
PHS
KS
Enumeration date
06/21/2006
Last updated
01/12/2024
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