Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 05-20200 | KS |
NPI | 1992753032 |
---|---|
Provider Name | Dr. Leslie E. F. Page |
First Address | Wichita, KS 67214-4915 |
Second Address | Wichita, KS 67214-4915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 23/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1598825606 | (05) | KS |
E82511 | (02) |