Provider Demographics
NPI:1003882408
Name:MINNS, GAROLD O (MD)
Entity Type:Individual
Prefix:
First Name:GAROLD
Middle Name:O
Last Name:MINNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1010 N. KANSAS
Mailing Address - Street 2:SUITE #3049
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214
Mailing Address - Country:US
Mailing Address - Phone:316-293-2650
Mailing Address - Fax:316-293-1882
Practice Address - Street 1:1001 N MINNEAPOLIS
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3199
Practice Address - Country:US
Practice Address - Phone:316-293-1840
Practice Address - Fax:316-293-2670
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-17299207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSB91000Medicare UPIN