Provider Demographics
NPI:1164523395
Name:L'HOMMEDIEU, STEPHEN CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:CHARLES
Last Name:L'HOMMEDIEU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 E DOUGLAS AVE STE 122
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-1032
Mailing Address - Country:US
Mailing Address - Phone:316-652-9191
Mailing Address - Fax:316-337-5531
Practice Address - Street 1:4601 E DOUGLAS AVE STE 122
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1032
Practice Address - Country:US
Practice Address - Phone:316-652-9191
Practice Address - Fax:316-337-5531
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04411111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS059977Medicare ID - Type Unspecified