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General NPI Number Information
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NPI Number | 1396048906
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Entity Type | Individual
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Provider Name | COLBY P SHINKLE PHYSICIAN ASSISTANT
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Gender | Male
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Dates
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Enumeration Date | 12/21/2010
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 4722 W KELLOGG DR
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City | WICHITA
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State | KS
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Zip | 67209-2508
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Country | US
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Telephone | 316-440-2565
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Fax |
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Provider Business Mailing Address
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Address Line | 3018 N ROCK BRIDGE ST
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City | DERBY
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State | KS
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Zip | 67037-8780
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Country | US
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Telephone | 316-640-2791
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1710I1003X
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Taxonomy Name | Independent Duty Medical Technicians
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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