Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 0322326 | KS |
NPI | 1013970441 |
---|---|
Provider Name | Darrell J Youngman |
First Address | Wichita, KS 67201-2969 |
Second Address | Wichita, KS 67208-3054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2006 |
Last Update Date | 05/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003719302 | MEDICARE (01) | KS |
100184900C | (05) | KS |
100184900K | (05) | KS |
120001354 | RAILROAD MEDICARE (01) | |
B69430 | (02) | KS |