Healthcare Provider Details

I. General information

NPI: 1972608503
Provider Name (Legal Business Name): DEBRA K SCHRAG P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 12/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 PATTERSON PKWY
ARKANSAS CITY KS
67005
US

IV. Provider business mailing address

PO BOX 1107
ARKANSAS CITY KS
67005
US

V. Phone/Fax

Practice location:
  • Phone: 620-221-6100
  • Fax: 620-221-7680
Mailing address:
  • Phone: 620-442-2500
  • Fax: 620-441-5971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number1500707
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15-00707
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: