Individual
DR. JOHN ALEXANDER DEBAUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 N HILLSIDE ST, WICHITA, KS 67214-4910
(316) 962-2030
(316) 962-7100
Mailing address
550 N HILLSIDE ST, WICHITA, KS 67214-4910
(316) 962-2030
(316) 962-7100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-29907
KS
208000000X
Pediatrics Physician
04-29907
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100327110I
—
KS
01
—
110784
BLUE CROSS BLUE SHIELD
KS
01
—
927503
FIRSTGUARD
KS
Enumeration date
04/17/2006
Last updated
02/23/2017
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