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Individual

ERNEST MCCLELLAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2610 N WOODLAWN ST, WICHITA, KS 67220-2729
(316) 858-2610
Mailing address
PO BOX 3374, WICHITA, KS 67201-3374
(316) 685-6236

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0415280
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
103848
BCBS
KS
Enumeration date
03/09/2006
Last updated
07/08/2007
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