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Physicians Radiology Body Imaging

Provider NPI: 1871575274

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 316-689-5050  Fax: 316-689-6192

Business Mailing Address:
3600 E HARRY ST  WICHITA, KS 67218-3713 US
Tel: 316-689-5050  Fax: --

NPI Information:
NPI: 1871575274
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Body Imaging

Other Provider Identifiers:

RR MEDICARE300134316KS01

American Medical Association 2012 taxonomy code information

Code: 2085R0202X





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