MEDICARE: GAROLD O MINNS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	04-17299	KS
2	207RI0200X	Infectious Disease Physician	04-17299	KS

General Provider Information

NPI Number	:	1003882408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAROLD O MINNS M.D.

Provider Business Mailing Address
First Line	:	1010 N. KANSAS
Second Line	:	SUITE #3049
City	:	WICHITA
State	:	KS
Zip	:	67214
Country	:	US
Telephone Number	:	316-293-2650
Fax Number	:	316-293-1882

Provider Business Practice Location Address
First Line	:	1001 N MINNEAPOLIS
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67214-3199
Country	:	US
Telephone Number	:	316-293-1840
Fax Number	:	316-293-2670

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	01/11/2010

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