Provider Demographics
NPI:1497802896
Name:WOMENS HEALTH & CONTINENCE CENTER
Entity Type:Organization
Organization Name:WOMENS HEALTH & CONTINENCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BRYANT
Authorized Official - Last Name:SHUCK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:316-260-3950
Mailing Address - Street 1:7015 E CENTRAL AVE
Mailing Address - Street 2:STE. #100
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-1943
Mailing Address - Country:US
Mailing Address - Phone:316-260-3950
Mailing Address - Fax:316-260-3953
Practice Address - Street 1:7015 E CENTRAL AVE
Practice Address - Street 2:STE. #100
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-1943
Practice Address - Country:US
Practice Address - Phone:316-260-3950
Practice Address - Fax:316-260-3953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0523677261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A10712Medicare UPIN
KS111046Medicare ID - Type Unspecified