Organization · NPI-2
Addiction Toxicology Of Kansas LLC
Internal Medicine · Wichita, KS
NPI number1356012181
StatusActive
Last updated in NPPESNov 9, 2021
Details
- NPI
- 1356012181
- Entity type
- Organization (NPI-2)
- Legal business name
- Addiction Toxicology Of Kansas LLC
- Organization subpart
- No
- Enumeration date
- Sep 22, 2021
- Certification date
- Nov 9, 2021
- Last updated
- Nov 9, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 207P00000X | Emergency Medicine | – | – | |
| 207PT0002X | Emergency Medicine, Medical Toxicology | – | – | |
| 207RA0401X | Internal Medicine, Addiction Medicine | – | – |
Practice location
3600 E Harry StWichita, KS 67218-3713
Phone 316-268-5000
Mailing address
1518 E Kalispell CtAndover, KS 67002-7982
Phone 252-864-5790
Authorized official
Ashley M R Haynes
Owner
2528645790
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