Provider Demographics
NPI:1033166152
Name:FEUILLE, EDMOND G II (MD)
Entity Type:Individual
Prefix:
First Name:EDMOND
Middle Name:G
Last Name:FEUILLE
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 N HILLSIDE ST
Mailing Address - Street 2:STE 510
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-4923
Mailing Address - Country:US
Mailing Address - Phone:316-685-0559
Mailing Address - Fax:316-685-0455
Practice Address - Street 1:551 N HILLSIDE ST
Practice Address - Street 2:STE 510
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4923
Practice Address - Country:US
Practice Address - Phone:316-685-0559
Practice Address - Fax:316-685-0455
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-16755207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100191800CMedicaid
057791Medicare ID - Type Unspecified
KS100191800CMedicaid