Provider Demographics
NPI:1598120461
Name:ROBERT J DOEL VAMC
Entity Type:Organization
Organization Name:ROBERT J DOEL VAMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRT
Authorized Official - Prefix:MISS
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:FRT
Authorized Official - Phone:316-685-2221
Mailing Address - Street 1:5500 E KELLOGG DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-1607
Mailing Address - Country:US
Mailing Address - Phone:316-685-2221
Mailing Address - Fax:316-239-2744
Practice Address - Street 1:5500 E KELLOGG DR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1607
Practice Address - Country:US
Practice Address - Phone:316-685-2221
Practice Address - Fax:316-239-2744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1609826924284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1609826924OtherNPI