Provider Demographics
NPI:1881673440
Name:HEIN, DANIEL J (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:HEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 E 6TH AVE
Mailing Address - Street 2:STE 1B
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-3144
Mailing Address - Country:US
Mailing Address - Phone:316-858-2610
Mailing Address - Fax:316-858-2793
Practice Address - Street 1:2610 N WOODLAWN BLVD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67220-2729
Practice Address - Country:US
Practice Address - Phone:316-858-2610
Practice Address - Fax:316-858-2793
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-23682207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100145840GMedicaid
KS100145840JMedicaid
KS100145840KMedicaid
KSP00606964OtherPALMETTO (RR MC)
KS100145840BMedicaid
KSE50019Medicare UPIN
KS100145840BMedicaid
KS100145840KMedicaid
KS004052024Medicare PIN
KS100145840JMedicaid