DERBY DERM
Organization (NPI-2)
Active
Physician Assistant
Provider Information
- NPI Number
1871771998- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 1121 N COLLEGE PARK ST SUITE # 400, DERBY, KS, 670373665
- Phone
- (316) 788-3376
- Fax
- (316) 788-3378
Specialties & Taxonomies
Physician Assistant
Primary License: KS #1500761