Provider Demographics
NPI:1740249341
Name:TOON, JULIE A (OD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:A
Last Name:TOON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:TOON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:2204 N LONGWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-1157
Mailing Address - Country:US
Mailing Address - Phone:316-204-3311
Mailing Address - Fax:316-722-7645
Practice Address - Street 1:2727 N MAIZE RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-7311
Practice Address - Country:US
Practice Address - Phone:316-722-1695
Practice Address - Fax:316-722-7645
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1537152WP0200X, 152WV0400X
KS1537-3152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100322210CMedicaid
U71963Medicare UPIN
KS650853Medicare ID - Type Unspecified