Basic Information
Provider Information
NPI: 1003882408
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MINNS
FirstName: GAROLD
MiddleName: O
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1010 N. KANSAS
Address2: SUITE #3049
City: WICHITA
State: KS
PostalCode: 67214
CountryCode: US
TelephoneNumber: 3162932650
FaxNumber: 3162931882
Practice Location
Address1: 1001 N MINNEAPOLIS
Address2:  
City: WICHITA
State: KS
PostalCode: 672143199
CountryCode: US
TelephoneNumber: 3162931840
FaxNumber: 3162932670
Other Information
ProviderEnumerationDate: 02/24/2006
LastUpdateDate: 01/11/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X04-17299KSN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RI0200X04-17299KSY Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

No ID Information.


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