Provider Demographics
NPI:1437166097
Name:BRUMFIELD, ELISHA J (DO)
Entity Type:Individual
Prefix:
First Name:ELISHA
Middle Name:J
Last Name:BRUMFIELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 N. KANSAS
Mailing Address - Street 2:SUITE # 3049
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-3199
Mailing Address - Country:US
Mailing Address - Phone:316-293-2650
Mailing Address - Fax:316-293-1882
Practice Address - Street 1:1010 N. KANSAS
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3199
Practice Address - Country:US
Practice Address - Phone:316-293-2650
Practice Address - Fax:316-293-1882
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-30993207R00000X
KS0530993208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS05-30993OtherLICENSE