Manuel Alfonso, MD

Individual provider Active NPI Anesthesiology Physician · Wichita, KS

NPI 1154433670 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1154433670
Entity type
Individual (NPI type 1)
Primary specialty
Anesthesiology Physician 207L00000X
License
15093 (KS)
Practice address
1947 N Founders St
Wichita, KS 67206-3548
Phone
(316) 613-4931
Fax
(316) 613-4937
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15093KSMDAnesthesiology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 15093 KS Yes

Addresses

Primary practice location

1947 N Founders St
Wichita, KS 67206-3548

Mailing address

PO Box 8035
Wichita, KS 67208-0035
Phone (316) 689-9135

Other identifiers

IdentifierTypeStateIssuer
16878OtherKSCOVENTRY
200101OtherKSHPK
16OtherKSPHS
000272FOtherKSBCBS
12149494OtherKSMULTIPLAN

Other providers in Wichita, KS

All providers in Wichita, KS · Anesthesiology Physician in Kansas

Sources for this page

Verify at the official NPI Registry.