Provider Demographics
NPI:1801827365
Name:DELANO, PATRICK J (PA C)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:J
Last Name:DELANO
Suffix:
Gender:M
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 W FIRST
Mailing Address - Street 2:PO BOX 1075
Mailing Address - City:SAINT FRANCIS
Mailing Address - State:KS
Mailing Address - Zip Code:67756-1075
Mailing Address - Country:US
Mailing Address - Phone:785-332-2682
Mailing Address - Fax:785-332-2516
Practice Address - Street 1:221 W FIRST
Practice Address - Street 2:
Practice Address - City:SAINT FRANCIS
Practice Address - State:KS
Practice Address - Zip Code:67756-1075
Practice Address - Country:US
Practice Address - Phone:785-332-2682
Practice Address - Fax:785-332-2516
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-00319363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS101707OtherBCBS
KS101707OtherBCBS
R55137Medicare UPIN