Individual
DESHANETT CLAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4723 E DOUGLAS AVE, WICHITA, KS 67218-1012
(316) 670-3800
Mailing address
4723 E DOUGLAS AVE, WICHITA, KS 67218-1012
(316) 670-3800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-44876
KS
208000000X
Pediatrics Physician
04-44876
KS
Other
Enumeration date
06/14/2017
Last updated
08/26/2021
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