Provider Demographics
NPI:1629041108
Name:GARTON, WESLEY EUGENE (OD)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:EUGENE
Last Name:GARTON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 S SENECA ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67213-4222
Mailing Address - Country:US
Mailing Address - Phone:316-264-7300
Mailing Address - Fax:316-264-3237
Practice Address - Street 1:2107 S SENECA ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67213-4222
Practice Address - Country:US
Practice Address - Phone:316-264-7300
Practice Address - Fax:316-264-3237
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1152-3152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS005333Medicare ID - Type Unspecified
KS0250730001Medicare NSC
KST43760Medicare UPIN