Individual
G ANDREW MCNICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1131 S CLIFTON AVE, SUITE B, WICHITA, KS 67218-2955
(316) 462-1040
(316) 462-1042
Mailing address
1131 S CLIFTON AVE, SUITE B, WICHITA, KS 67218-2955
(316) 462-1040
(316) 462-1042
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-16812
KS
Other
Enumeration date
06/17/2006
Last updated
01/21/2015
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