Individual
PAUL A CALLAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
850 N HILLSIDE ST, WICHITA, KS 67214-4914
(316) 962-3070
(316) 962-3265
Mailing address
PO BOX 47490, WICHITA, KS 67201-7490
(316) 962-3150
(316) 962-7334
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-18705
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100135220B
—
KS
01
—
101125
BLUE CROSS BLUE SHIELD
KS
01
—
334991
FIRSTGUARD
KS
Enumeration date
04/17/2006
Last updated
03/27/2012
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