Boomer, Jeffrey A
Boomer, Jeffrey A is an sole proprietor health care provider with primary practice located at 1100 N Topeka , Wichita KS 67214-2810. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Boomer, Jeffrey A can be contacted via phone (316) 263-6273.Contact Information
Primary practice address
1100 N Topeka
Wichita KS 67214-2810
Phone: (316) 263-6273
Fax: (316) 263-5568
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 04-31763 | Kansas |
Profile Details
| NPI number | 1396726964 |
|---|---|
| LBN Legal business name | Boomer, Jeffrey A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 9th, 2005 |
| Last updated | Dec 23rd, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396726964 | NPPES |
| Kansas | MEDICAID | 200421070C |
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