Healthcare Provider Details

I. General information

NPI: 1295868917
Provider Name (Legal Business Name): ANDREW W GAUT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 W 7TH ST
CHANUTE KS
66720-2551
US

IV. Provider business mailing address

629 S PLUMMER AVE
CHANUTE KS
66720-1928
US

V. Phone/Fax

Practice location:
  • Phone: 620-433-3838
  • Fax: 620-431-5827
Mailing address:
  • Phone: 620-431-4000
  • Fax: 620-431-7556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number32874
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number37162
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number25845
License Number StateNE
# 4
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number04-52930
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: