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General NPI Number Information
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NPI Number | 1477073575
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Entity Type | Individual
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Provider Name | DYLLAN LANDRY MD
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Gender | Male
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Dates
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Enumeration Date | 06/21/2017
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 1301 W 12TH AVE STE 301
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City | EMPORIA
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State | KS
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Zip | 66801-2590
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Country | US
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Telephone | 620-343-2376
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Fax | 620-343-5987
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Provider Business Mailing Address
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Address Line | 1201 W 12TH AVE
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City | EMPORIA
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State | KS
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Zip | 66801-2504
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Country | US
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Telephone | 620-343-6800
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Fax | 620-341-7821
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | E-15410
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 04-50964
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License Number State | KS
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