Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 2011019435 | MO |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 04-41044 | KS |
NPI | 1497042444 |
---|---|
Provider Name | Dr. Simon Patrick Patton |
First Address | Wichita, KS 67208-0035 |
Second Address | Wichita, KS 67218 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2011 |
Last Update Date | 05/09/2018 |