Provider Demographics
NPI:1780642793
Name:LARKIN, GARY S (DC)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:S
Last Name:LARKIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3351 E 47TH ST S
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67216-3059
Mailing Address - Country:US
Mailing Address - Phone:316-524-5700
Mailing Address - Fax:316-524-0707
Practice Address - Street 1:3351 E 47TH ST S
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67216-3059
Practice Address - Country:US
Practice Address - Phone:316-524-5700
Practice Address - Fax:316-524-0707
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04101111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS060756OtherBLUE CROSS BLUE SHIELD
KS060756OtherBLUE CROSS BLUE SHIELD
KSU40576Medicare UPIN