Provider Demographics
NPI:1508990847
Name:ARENSBERG OPTOMETRY INC
Entity Type:Organization
Organization Name:ARENSBERG OPTOMETRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:ARENSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:OPTOMETRIST
Authorized Official - Phone:316-681-3937
Mailing Address - Street 1:345 N HILLSIDE
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:
Practice Address - Street 1:345 N HILLSIDE ST STE 1B
Practice Address - Street 2:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1319152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS065100Medicare PIN