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NPI Code Detail

MEDICARE: DR. JOHN ALEXANDER DEBAUN M.D.

MEDICARE: DR. JOHN ALEXANDER DEBAUN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician04-29907KS
2208000000XPediatrics Physician04-29907KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1110784OTHERKSBLUE CROSS BLUE SHIELD
2927503OTHERKSFIRSTGUARD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861457624
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN ALEXANDER DEBAUN M.D.
Provider Business Mailing Address
First Line : 550 N HILLSIDE ST
Second Line :
City : WICHITA
State : KS
Zip : 67214-4910
Country : US
Telephone Number : 316-962-2030
Fax Number : 316-962-7100
Provider Business Practice Location Address
First Line : 550 N HILLSIDE ST
Second Line :
City : WICHITA
State : KS
Zip : 67214-4910
Country : US
Telephone Number : 316-962-2030
Fax Number : 316-962-7100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2006
Last Update Date : 06/05/2026

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