Provider Demographics
NPI:1386647196
Name:EGELHOF, RICHARD HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HENRY
Last Name:EGELHOF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3730 N RIDGE RD
Mailing Address - Street 2:STE 100
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1228
Mailing Address - Country:US
Mailing Address - Phone:316-462-6200
Mailing Address - Fax:316-462-6214
Practice Address - Street 1:3730 N RIDGE RD
Practice Address - Street 2:STE 100
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1228
Practice Address - Country:US
Practice Address - Phone:316-462-6200
Practice Address - Fax:316-462-6214
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS0415947207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100769Medicare ID - Type UnspecifiedPROVIDER NUMBER
KSB68816Medicare UPIN