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NPI Code Detail

MEDICARE: BRIAN DAVID CALKINS PA-C

MEDICARE: BRIAN DAVID CALKINS PA-C
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
1363A00000XPhysician Assistant00361KS

General Provider Information

NPI Number : 1922194505
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN DAVID CALKINS PA-C
Provider Business Mailing Address
First Line : 7921 ROCKWOOD DR
Second Line :
City : MILFORD
State : KS
Zip : 66514
Country : US
Telephone Number : 785-210-1681
Fax Number :
Provider Business Practice Location Address
First Line : IRWIN ARMY COMMUNITY HOSIPITAL
Second Line : 600 CASSION HILL RD,
City : FORT RILEY
State : KS
Zip : 66442-5037
Country : US
Telephone Number : 785-239-7155
Fax Number : 785-239-7364
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 07/08/2007

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