Internal Medicine, Endocrinology, Diabetes & Metabolism
FORM ASSOCIATES, P.A.
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1740971605 · enumerated 2023-05-19 · record updated 2026-03-18. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: TROY RUSSELL MD, Owner · (617) 505-1520
Addresses and phones
- Mailing address 109 STATE ST., 5TH FL, BOSTON, MA, 02109-2906 (617) 505-1520 Fax (617) 928-8401 Google Maps Apple Maps OpenStreetMap
- Practice location 801 E DOUGLAS AVE FL 2, WICHITA, KS, 67202-3548 (617) 505-1520 Fax (617) 928-8401 Google Maps Apple Maps OpenStreetMap
Specialties
- Family Medicine 207Q00000X
- Clinic/Center, Health Services 261QH0100X
- Internal Medicine, Endocrinology, Diabetes & Metabolism 207RE0101X · Primary
In this directory
KS Sedgwick County Wichita Internal Medicine, Endocrinology, Diabetes & Metabolism
Locations and evidence
-
Practice location
WICHITA, KS, 672023548
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.