Provider Demographics
NPI:1245740018
Name:KANSAS ENDOSCOPY LLC
Entity Type:Organization
Organization Name:KANSAS ENDOSCOPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLTING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-928-8956
Mailing Address - Street 1:3121 N WEBB RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-8119
Mailing Address - Country:US
Mailing Address - Phone:316-261-3130
Mailing Address - Fax:316-261-3275
Practice Address - Street 1:3121 N WEBB RD STE 107
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-8119
Practice Address - Country:US
Practice Address - Phone:316-219-2828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KANSAS ENDOSCOPY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty