Individual
MR. MICHAEL A CLOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
4722 W KELLOGG DR, WICHITA, KS 67209-2508
(316) 440-2565
(316) 440-2750
Mailing address
4722 W KELLOGG DR, WICHITA, KS 67209-2508
(316) 440-2565
(316) 440-2750
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1501038
KS
Other
Enumeration date
10/19/2006
Last updated
03/27/2015
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