Provider Demographics
NPI:1811095938
Name:HEMPHILL, WAYNE R (OD)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:R
Last Name:HEMPHILL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13839 S MUR LEN RD
Mailing Address - Street 2:STE. A
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1652
Mailing Address - Country:US
Mailing Address - Phone:913-782-5993
Mailing Address - Fax:
Practice Address - Street 1:13839 S MUR LEN RD
Practice Address - Street 2:STE. A
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1652
Practice Address - Country:US
Practice Address - Phone:913-782-5993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1305152W00000X, 152WC0802X, 152WP0200X, 152WS0006X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS15406017OtherBLUE CROSS KANSAS CITY
KS520722OtherBLUE CROSS KANSAS
KSU17880Medicare UPIN
KSQ061206Medicare ID - Type UnspecifiedMEDICARE NUMBER