Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 36821 | KS |
N | 207L00000X | Anesthesiologist | 7218 | KS |
NPI | 1013145572 |
---|---|
Provider Name | Scott D Mclaren |
First Address | Wichita, KS 67201-2897 |
Second Address | Wichita, KS 67214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2009 |
Last Update Date | 06/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2014018782 | LICENSE (01) | MO |