Provider Demographics
NPI:1982601886
Name:BINGAMAN, ROBERT WESLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WESLEY
Last Name:BINGAMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:551 N HILLSIDE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-4923
Mailing Address - Country:US
Mailing Address - Phone:316-263-0296
Mailing Address - Fax:316-263-9523
Practice Address - Street 1:818 N EMPORIA ST STE 200
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3788
Practice Address - Country:US
Practice Address - Phone:316-263-0296
Practice Address - Fax:316-263-9523
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0415426208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100085380BMedicaid
KS100085380BMedicaid
KS047154Medicare ID - Type Unspecified