Provider Demographics
NPI:1275596231
Name:FAULK, L CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:L
Middle Name:CHRISTINE
Last Name:FAULK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LUBINDA
Other - Middle Name:CHRISTINE
Other - Last Name:FAULK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1010 N KANSAS ST
Mailing Address - Street 2:SUITE #3049
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-3124
Mailing Address - Country:US
Mailing Address - Phone:316-293-2650
Mailing Address - Fax:316-293-1882
Practice Address - Street 1:1010 N KANSAS ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3124
Practice Address - Country:US
Practice Address - Phone:316-293-2650
Practice Address - Fax:316-293-1882
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-25911207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSG23595Medicare UPIN