Provider Demographics
NPI:1780605543
Name:ROBERT J DOLE VAMC
Entity type:Organization
Organization Name:ROBERT J DOLE VAMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ABC CERTIFIED ORTHOTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BEELER
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:316-685-2221
Mailing Address - Street 1:5500 E KELLOGG DR
Mailing Address - Street 2:PROSTHETICS/ORTHOTICS
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-1607
Mailing Address - Country:US
Mailing Address - Phone:316-685-2221
Mailing Address - Fax:316-634-3081
Practice Address - Street 1:5500 E KELLOGG DR
Practice Address - Street 2:PROSTHETICS/ORTHOTICS
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1607
Practice Address - Country:US
Practice Address - Phone:316-685-2221
Practice Address - Fax:316-634-3081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSV130213OtherORTHOTIST