Provider Demographics
NPI:1740207513
Name:RIVER CITY CARDIAC AND VASCULAR INSTITUTE
Entity Type:Organization
Organization Name:RIVER CITY CARDIAC AND VASCULAR INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:AM
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:316-462-1075
Mailing Address - Street 1:3730 N RIDGE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1227
Mailing Address - Country:US
Mailing Address - Phone:316-462-1075
Mailing Address - Fax:316-462-1078
Practice Address - Street 1:3730 N RIDGE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1227
Practice Address - Country:US
Practice Address - Phone:316-462-1075
Practice Address - Fax:316-462-1078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1871584714OtherBERNARD A. LANDRY, MD
KS1619973906OtherJAMES AM SMITH, DO
KS1871584714OtherBERNARD A. LANDRY, MD