Healthcare Provider Details

I. General information

NPI: 1922164524
Provider Name (Legal Business Name): DARREN KLISH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1709 W 7TH ST
CHANUTE KS
66720-2505
US

IV. Provider business mailing address

1709 W 7TH ST
CHANUTE KS
66720-2505
US

V. Phone/Fax

Practice location:
  • Phone: 620-431-4815
  • Fax: 620-431-4816
Mailing address:
  • Phone: 620-431-4815
  • Fax: 620-431-4816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number431633
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: