Individual
KATHLEEN T DANG-PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3311 E MURDOCK ST, WICHITA, KS 67208-3054
(316) 689-9335
(316) 689-9364
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9102
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
00613
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003719071
MEDICARE
—
05
—
200370440A
—
KS
Enumeration date
08/07/2006
Last updated
02/27/2017
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