Individual
BRIAN L DEBROT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2610 N WOODLAWN ST, WICHITA, KS 67220-2729
(316) 858-2610
(316) 858-2793
Mailing address
2610 N WOODLAWN ST, WICHITA, KS 67220-2729
(316) 858-2610
(316) 858-2793
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
04-28277
KS
207R00000X
Internal Medicine Physician
04-28277
KS
208000000X
Pediatrics Physician
04-28277
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100358250E
—
KS
05
—
100358250F
—
KS
05
—
100358250G
—
KS
05
—
100358250H
—
KS
01
—
P00615211
RR MEDICARE (PALMETTO)
KS
Enumeration date
01/06/2006
Last updated
12/17/2010
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