Provider Demographics
NPI:1598731226
Name:KISER, JOHN L (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:L
Last Name:KISER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3243 E MURDOCK ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-3052
Mailing Address - Country:US
Mailing Address - Phone:316-685-6222
Mailing Address - Fax:316-685-1273
Practice Address - Street 1:3243 E MURDOCK ST
Practice Address - Street 2:SUITE 404
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-3052
Practice Address - Country:US
Practice Address - Phone:316-685-6222
Practice Address - Fax:316-685-1273
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS13350208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSB68361Medicare UPIN
KS29999Medicare ID - Type Unspecified