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Russell Icke, OD

NPI 1134113319 · on the registry since 2005 · sole proprietor

Practice

Address
7050 E Lincoln St
Wichita, KS 67207
Phone
(316) 683-9671
Fax
(316) 683-0168

Registry record

Primary taxonomy
152W00000X
152W00000X
Licence states on file
KS
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2010-07-28

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Kansas