Provider Demographics
NPI:1811188758
Name:STARK, ANA ISABEL (MD)
Entity type:Individual
Prefix:MRS
First Name:ANA
Middle Name:ISABEL
Last Name:STARK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:ANA
Other - Middle Name:ISABEL
Other - Last Name:VIGIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1035 N EMPORIA
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-2998
Mailing Address - Country:US
Mailing Address - Phone:316-263-7285
Mailing Address - Fax:316-263-2666
Practice Address - Street 1:1035 N EMPORIA
Practice Address - Street 2:SUITE 105
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-2998
Practice Address - Country:US
Practice Address - Phone:316-263-7285
Practice Address - Fax:316-263-2666
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-47770207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology