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Individual

DR. PAUL H DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7111 E 21ST STREET N, SUITE A, WICHITA, KS 67206
(316) 684-2851
(316) 686-7338
Mailing address
7111 E 21ST STREET N, SUITE A, WICHITA, KS 67206
(316) 684-2851
(316) 686-7338

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-15371
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080186352
RAILROAD MEDICARE
KS
05
100086530E
KS
05
100416440A
KS
01
101598
CHAMPUS
KS
01
110718
BLUE CROSS
KS
01
621151
FIRSTGUARD
KS
Enumeration date
05/31/2005
Last updated
10/16/2012
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