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Specialty details in registry · Shawnee, KS

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At a glance

21620 Midland Dr, Shawnee, KS 66218-9064

NPPES record updated Jul 22, 2016. Public records can lag behind changes at a practice.

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Practice location

21620 Midland Dr
Shawnee, KS 66218-9064

Professional details: NPI, taxonomy & registry record

NPI1730532920

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 1223G0001X
Enumeration date: Jul 22, 2016
Record updated: Jul 22, 2016

More registry details

Provider type: Organization · Type 2
Other reported name: <UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

1223G0001X · Primary

License reported: 61187 KS

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

21620 Midland Dr
Shawnee, KS 66218-9064

Phone: (913) 268-1337

Mailing address

1700 E IRON AVE

SALINA, KS 674013401

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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