Provider Demographics
NPI:1730153008
Name:WICHITA PSYCHIATRIC CONSULTANTS LLC
Entity type:Organization
Organization Name:WICHITA PSYCHIATRIC CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE CREDENTIALING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:TURCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-686-6303
Mailing Address - Street 1:PO BOX 26303
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73126-0303
Mailing Address - Country:US
Mailing Address - Phone:316-686-6303
Mailing Address - Fax:316-686-6764
Practice Address - Street 1:9415 EAST HARRY
Practice Address - Street 2:BLDG 800
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-5072
Practice Address - Country:US
Practice Address - Phone:316-686-6303
Practice Address - Fax:316-686-6764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110329Medicare ID - Type Unspecified