Individual
PAUL HALDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
750 W D AVE, KINGMAN, KS 67068-1266
(620) 532-3147
(620) 532-0167
Mailing address
750 W D AVE, KINGMAN, KS 67068-1266
(620) 532-3147
(620) 532-0167
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01738
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30003916630001
—
KS
Enumeration date
09/09/2014
Last updated
11/08/2022
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