Basic Information
Provider Information
NPI: 1518070416
EntityType: 2
ReplacementNPI:  
OrganizationName: ANESTHESIA CONSULTING SERVICES, PA
LastName:  
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Mailing Information
Address1: PO BOX 2897
Address2:  
City: WICHITA
State: KS
PostalCode: 672012897
CountryCode: US
TelephoneNumber: 8776497812
FaxNumber: 9183922941
Practice Location
Address1: 929 N SAINT FRANCIS ST
Address2:  
City: WICHITA
State: KS
PostalCode: 672143821
CountryCode: US
TelephoneNumber: 3162685000
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/16/2006
LastUpdateDate: 10/04/2018
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: CAUGHLIN
AuthorizedOfficialFirstName: GERALD
AuthorizedOfficialMiddleName: MICHAEL
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 3166340857
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
100216890B05KS MEDICAID
CQ230201KSRR MEDICAREOTHER
CQ230701KSRR MEDICAREOTHER
11001701KSBCBS KSOTHER


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