Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 04-40724 | KS |
NPI | 1043659527 |
---|---|
Provider Name | Aaron Scott Thiessen |
First Address | Wichita, KS 67208-0035 |
Second Address | Wichita, KS 67206-3548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2013 |
Last Update Date | 11/01/2021 |