Provider Demographics
NPI:1346236734
Name:ARENSBERG, WILLIAM CHRISTOPHER (OD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CHRISTOPHER
Last Name:ARENSBERG
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 1:345 N HILLSIDE ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-4905
Mailing Address - Country:US
Mailing Address - Phone:316-681-3937
Mailing Address - Fax:316-681-0318
Practice Address - Street 1:345 N HILLSIDE ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4905
Practice Address - Country:US
Practice Address - Phone:316-681-3937
Practice Address - Fax:316-681-0318
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1319-3152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100219680AMedicaid
KS100219680AMedicaid
KSKA1687001Medicare PIN