Individual
CAMILO H PALACIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1640 E TALL TREE, DERBY, KS 67037
(316) 789-8222
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9102
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
26049
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040958
BCBS
KS
05
—
100183750A
—
KS
01
—
121494389
MULTIPLAN
KS
01
—
16950
COVENTRY
KS
01
—
300779
HPK
KS
01
—
4692
PHS
KS
Enumeration date
06/18/2006
Last updated
07/21/2022
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