Provider Demographics
NPI:1841419389
Name:WYCHE, JAMES STANTON
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:STANTON
Last Name:WYCHE
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 1:11319 RIMROCK DR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-9116
Mailing Address - Country:US
Mailing Address - Phone:785-477-0855
Mailing Address - Fax:
Practice Address - Street 1:509 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-2918
Practice Address - Country:US
Practice Address - Phone:785-223-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician