Basic Information
| Provider Information | |||||||||
| NPI: | 1225324783 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILSAP | ||||||||
| FirstName: | TEOLINDA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 47490 | ||||||||
| Address2: | |||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672017490 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3169623100 | ||||||||
| FaxNumber: | 3169623132 | ||||||||
| Practice Location | |||||||||
| Address1: | 620 N CARRIAGE PKWY | ||||||||
| Address2: | |||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672084501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3169623100 | ||||||||
| FaxNumber: | 3169623132 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2011 | ||||||||
| LastUpdateDate: | 02/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 7692 | KS | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.