Centerwell Senior Primary Care Ks PA

NPI #1215757778 in Wichita, Kansas

Provider Information

NPI Number: 1215757778
Entity Type: Organization
Organization Name: Centerwell Senior Primary Care Ks PA
Subpart: Yes (part of a larger organization)
Parent Organization: CENTERWELL SENIOR PRIMARY CARE KS PA
Primary Specialty: Internal Medicine
Enumeration Date: Oct 10, 2024
Last Updated: Jan 24, 2025

Practice Location

Address: 2402 E 13TH ST N
City: Wichita
State: Kansas
ZIP Code: 67214-2102
Phone: (316) 867-6444

Authorized Official

Name: ANGIE MARTINEZ
Title: SENIOR CREDENTIALING PROFESSIONAL
Phone: (407) 447-7120

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
General Practice	208D00000X
Non-Pharmacy Dispensing Site	332900000X
Internal Medicine	207R00000X	Primary

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