Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 04-28302 | KS |
N | 207XS0106X | Orthopaedic Hand Surgeon | 04-28302 | KS |
Y | 2086S0105X | Surgery of the Hand | 04-28302 | KS |
NPI | 1053388611 |
---|---|
Provider Name | Dr. David T Gwyn |
First Address | Wichita, KS 67226-8112 |
Second Address | Wichita, KS 67226-8112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 03/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200266490A | (05) | KS |
I144110 | (02) | KS |