MEDICARE: MRS. MALISSA KAY PAXTON RPAC

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	363AM0700X	Medical Physician Assistant	15-00798	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00099501	OTHER	KS	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	15-00798	OTHER	KS	KS ST BOARD LICENSE

General Provider Information

NPI Number	:	1144321902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MALISSA KAY PAXTON RPAC

Provider Business Mailing Address
First Line	:	1305 PARKWOOD CT
Second Line	:
City	:	DERBY
State	:	KS
Zip	:	67037-8897
Country	:	US
Telephone Number	:	316-789-0240
Fax Number	:

Provider Business Practice Location Address
First Line	:	606 MULBERRY RD
Second Line	:
City	:	DERBY
State	:	KS
Zip	:	67037-3532
Country	:	US
Telephone Number	:	316-788-3787
Fax Number	:	316-788-6930

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

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	07/19/2013

Similar Medicare Providers

1144215278 — AMY MEEK MS, LCMFT
Practice Location Address:

606 MULBERRY RD
DERBY, KS
67037-3532

Practice Phone: 316-788-4335
Practice Fax: 316-262-7202

1942275342 — DR. ROGER LYNN THOMAS DO
Practice Location Address:

606 MULBERRY RD
DERBY, KS
67037-3532

Practice Phone: 316-788-3787
Practice Fax: 316-788-6930

1922073337 — DR. GLEN RAY PATTON DO
Practice Location Address:

606 MULBERRY RD
DERBY, KS
67037-3532

Practice Phone: 316-788-3787
Practice Fax: 316-788-6930

1952323842 — KATHERINE JEAN CATES PANAKOS DO
Practice Location Address:

606 N MULBERRY RD
DERBY, KS
67037-3532

Practice Phone: 316-788-3787
Practice Fax:

1114949179 — CONSTANTINE PAUL PANAKOS DO
Practice Location Address:

606 N MULBERRY RD , TANGLEWOOD MEDICAL CENTER, PA
DERBY, KS
67037-3532

Practice Phone: 316-788-3787
Practice Fax: 316-788-2618

1124129911 — MR. EDWIN LYSLE PRICE RPAC
Practice Location Address:

606 MULBERRY RD
DERBY, KS
67037-3532

Practice Phone: 316-788-3787
Practice Fax: 316-788-6930

Directions to “ MRS. MALISSA KAY PAXTON RPAC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.