Provider Demographics
NPI:1184657983
Name:NEOSOM EAST, LLC
Entity Type:Organization
Organization Name:NEOSOM EAST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DUKE
Authorized Official - Middle Name:C
Authorized Official - Last Name:NAIPOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-683-2323
Mailing Address - Street 1:1841 N ROCK ROAD CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-4202
Mailing Address - Country:US
Mailing Address - Phone:316-616-6160
Mailing Address - Fax:316-616-6161
Practice Address - Street 1:9419 COMMON BROOK RD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-7536
Practice Address - Country:US
Practice Address - Phone:410-902-7141
Practice Address - Fax:410-902-7143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic