Basic Information
| Provider Information | |||||||||
| NPI: | 1538585831 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KANSAS SLEEP MEDICINE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 551 N HILLSIDE ST | ||||||||
| Address2: | STE 320 | ||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672144923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3166851367 | ||||||||
| FaxNumber: | 3166859388 | ||||||||
| Practice Location | |||||||||
| Address1: | 551 N HILLSIDE ST | ||||||||
| Address2: | STE 320 | ||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672144923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3166851367 | ||||||||
| FaxNumber: | 3166859388 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/11/2014 | ||||||||
| LastUpdateDate: | 03/11/2014 | ||||||||
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| AuthorizedOfficialLastName: | LOHNES | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 3166851367 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 0418565 | KS | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.