Provider Demographics
NPI:1518932011
Name:WICHITA EAR CLINIC, PA
Entity Type:Organization
Organization Name:WICHITA EAR CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARI
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-686-6608
Mailing Address - Street 1:9350 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-4999
Mailing Address - Country:US
Mailing Address - Phone:316-686-6608
Mailing Address - Fax:316-686-3624
Practice Address - Street 1:9350 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2555
Practice Address - Country:US
Practice Address - Phone:316-686-6608
Practice Address - Fax:316-686-3624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-20
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & NeurotologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110245OtherBLUE CROSS/BLUE SHIELD KS
KS3257OtherPREFERRED HEALTH SYSTEMS
KSCD7286OtherRAILROAD MEDICARE
KSCD7286OtherRAILROAD MEDICARE
KS3257OtherPREFERRED HEALTH SYSTEMS