Most Relevant Information
Provider Data
| NPI Number: | 1003183062 |
| Provider Name: | NICKLAUS JAMES RICHMOND O.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 152W00000X |
| Specialty: | Optometrist |
| License Number: | 1911 |
Most Important Dates
| Enumeration Date: | 11/18/2011 |
| Last Updated: | 02/24/2017 |
Provider Practice Location
1202 W MAPLE ST
WICHITA
KS
672133916
Practice Location Phone/Fax
| Phone: | 3162623716 |
| Fax: | 3162620784 |
Provider Mailing Location
1202 W MAPLE ST
WICHITA
KS
672133916
Provider Mailing Phone/Fax
| Phone: | 3162623716 |
| Fax: | 3162620784 |