Provider Demographics
NPI:1518000397
Name:WORLEY, PAULA A (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:A
Last Name:WORLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4722 W KELLOGG DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-2508
Mailing Address - Country:US
Mailing Address - Phone:316-440-2565
Mailing Address - Fax:316-440-2750
Practice Address - Street 1:4722 W KELLOGG DR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209-2508
Practice Address - Country:US
Practice Address - Phone:316-440-2565
Practice Address - Fax:316-440-2750
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-30765207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS171806Medicare ID - Type UnspecifiedPRACTICE ID NUMBER
KS100212250AMedicaid