Provider Demographics
NPI:1922194505
Name:CALKINS, BRIAN DAVID (PA-C)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:DAVID
Last Name:CALKINS
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 1:7921 ROCKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:KS
Mailing Address - Zip Code:66514
Mailing Address - Country:US
Mailing Address - Phone:785-210-1681
Mailing Address - Fax:
Practice Address - Street 1:IRWIN ARMY COMMUNITY HOSIPITAL
Practice Address - Street 2:600 CASSION HILL RD,
Practice Address - City:FORT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442-5037
Practice Address - Country:US
Practice Address - Phone:785-239-7155
Practice Address - Fax:785-239-7364
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS00361363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant