Individual
COLE GILLENWATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7111 E 21ST ST N STE A, WICHITA, KS 67206-1078
(316) 684-2851
(316) 683-5239
Mailing address
1010 N KANSAS ST, WICHITA, KS 67214-3124
(316) 962-3070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-40466
KS
Other
Enumeration date
05/27/2016
Last updated
07/19/2019
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