Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 04-25805 | KS |
NPI | 1043290679 |
---|---|
Provider Name | Mr. Kris Lewonowski |
First Address | Wichita, KS 67220-2729 |
Second Address | Wichita, KS 67220-2729 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 17/06/2013 |