Provider Demographics
NPI:1326200239
Name:WHEELER, KENNETH ADAM (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:ADAM
Last Name:WHEELER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7732 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2155
Mailing Address - Country:US
Mailing Address - Phone:316-686-0844
Mailing Address - Fax:
Practice Address - Street 1:7732 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2155
Practice Address - Country:US
Practice Address - Phone:316-686-0844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-14072183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS$$$$$$$$$OtherSOCIAL SECURITY