Organization
THE DERMATOLOGY CLINIC, P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTHA SELFRIDGE HOUSHOLDER M.D. (PRESIDENT)
(316) 685-4395
Entity
Organization
Contact information
Practice address
835 N HILLSIDE ST, WICHITA, KS 67214-4913
(316) 685-4395
(316) 685-1149
Mailing address
835 N HILLSIDE ST, WICHITA, KS 67214-4913
(316) 685-4395
(316) 685-1149
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
—
—
Other
Enumeration date
03/22/2006
Last updated
08/22/2020
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