Provider Demographics
NPI:1235744665
Name:DISKIN, KADEN (OD)
Entity Type:Individual
Prefix:DR
First Name:KADEN
Middle Name:
Last Name:DISKIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2148 N WESTFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-5378
Mailing Address - Country:US
Mailing Address - Phone:316-250-8324
Mailing Address - Fax:
Practice Address - Street 1:2701 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-3479
Practice Address - Country:US
Practice Address - Phone:620-663-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2135152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist