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Contact Information

ENNOBLE HC KS III LLC
801 E DOUGLAS AVE FL 2ND
WICHITA, KS67202-3515
 Phone: 551-295-8223
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for ENNOBLE HC KS III LLC

NPI Number 1568344471
LBN Legal business name ENNOBLE HC KS III LLC
Authorized official MARK BRADSHAW - (PHYSICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 07/22/2025
Last updated 08/01/2025 - About 10 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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