NPI 1114039583 · live from the CMS NPI Registry
Henry Lee Bumgardner, O.D.
Optometrist in Wichita, KS. National Provider Identifier 1114039583, active.
NPI record
| NPI | 1114039583 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 2205 S Seneca St, Wichita, KS 67213 |
| Practice phone | 316-264-9131 |
| Enumerated | August 31, 2006 |
| Last updated | October 12, 2008 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 997-3 (KS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.