Individual
LARRY E CHUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, MPAS
Contact information
Practice address
22 MDG, 57950 LEAVENWORTH ST, MCCONNELL AFB, KS 67221-3506
(316) 759-1970
Mailing address
1806 N DOREEN ST, WICHITA, KS 67206-1053
(316) 347-1882
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
15-02047
KS
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
10/24/2005
Last updated
03/25/2025
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