Provider Demographics
NPI:1033153234
Name:GAWITH, JAYME L (DO)
Entity Type:Individual
Prefix:DR
First Name:JAYME
Middle Name:L
Last Name:GAWITH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 N WOODSTONE DR
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-9318
Mailing Address - Country:US
Mailing Address - Phone:316-733-7140
Mailing Address - Fax:
Practice Address - Street 1:9390 E. CENRAL AVE.
Practice Address - Street 2:STE 103
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206
Practice Address - Country:US
Practice Address - Phone:316-636-9393
Practice Address - Fax:316-636-9398
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-4820111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS660118Medicare ID - Type Unspecified