Basic Information
| Provider Information | |||||||||
| NPI: | 1922194505 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CALKINS | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | DAVID | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7921 ROCKWOOD DR | ||||||||
| Address2: | |||||||||
| City: | MILFORD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852101681 | ||||||||
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| Practice Location | |||||||||
| Address1: | IRWIN ARMY COMMUNITY HOSIPITAL | ||||||||
| Address2: | 600 CASSION HILL RD, | ||||||||
| City: | FORT RILEY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 664425037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852397155 | ||||||||
| FaxNumber: | 7852397364 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 00361 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.