Provider Demographics
NPI:1073511051
Name:CONARD, SHAWN L (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:L
Last Name:CONARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1121 S CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-2912
Mailing Address - Country:US
Mailing Address - Phone:316-689-5500
Mailing Address - Fax:316-665-6082
Practice Address - Street 1:1121 S CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-2912
Practice Address - Country:US
Practice Address - Phone:316-689-5500
Practice Address - Fax:316-665-6082
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0429707207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100427920DMedicaid
KS100427920EMedicaid
KS105224Medicare Oscar/Certification
KS100427920EMedicaid
KS100427920DMedicaid