Provider Demographics
NPI:1578347092
Name:KORBEL, JOHN P
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:KORBEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 N AMIDON AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-2122
Mailing Address - Country:US
Mailing Address - Phone:316-768-6718
Mailing Address - Fax:316-252-1255
Practice Address - Street 1:1999 N AMIDON AVE STE 110
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-2122
Practice Address - Country:US
Practice Address - Phone:316-768-6718
Practice Address - Fax:316-252-1255
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4496235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist