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Individual
DICKY LEE PAIGE
Active
Individual
DICKY LEE PAIGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-00378
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023170
BLUECROSS BLUE SHIELD KS
KS
Enumeration date
07/26/2006
Last updated
07/08/2007
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