Provider Demographics
NPI:1508141052
Name:CEPEDA BRITO, JOSE RAMON (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:RAMON
Last Name:CEPEDA BRITO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9911 E 21ST ST N
Mailing Address - Street 2:APT 703
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3551
Mailing Address - Country:US
Mailing Address - Phone:939-579-1629
Mailing Address - Fax:
Practice Address - Street 1:550 N HILLSIDE ST
Practice Address - Street 2:WESLEY MEDICAL CENTER
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4910
Practice Address - Country:US
Practice Address - Phone:316-962-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR28912R207P00000X
OH124158207P00000X
NY275644207P00000X
KS0438429207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine