Individual
DR. KEVIN K WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4101 ANDERSON AVE, MANHATTAN, KS 66503-7588
(785) 587-4101
(785) 587-9090
Mailing address
4101 ANDERSON AVE, MANHATTAN, KS 66503-7588
(785) 587-4101
(785) 587-9090
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0419652
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100196460B
—
KS
Enumeration date
06/06/2006
Last updated
07/25/2013
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