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Individual

AULTON DALE CHISUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1509 W TRUMAN RD, EMERGENCY DEPARTMENT, INDEPENDENCE, MO 64050-3436
(913) 469-1488
(913) 469-1441
Mailing address
15954 S BROUGHAM DR, OLATHE, KS 66062-7044
(913) 780-6320
(913) 469-1441

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2005026115
MO
207P00000X
Emergency Medicine Physician
F1449
TX

Other

Enumeration date
11/17/2005
Last updated
07/08/2007
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