Provider Demographics
NPI:1023091303
Name:KIRKPATRICK, JON (DO)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:KIRKPATRICK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N MAIZE RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-4655
Mailing Address - Country:US
Mailing Address - Phone:316-721-5000
Mailing Address - Fax:316-721-6604
Practice Address - Street 1:501 N MAIZE RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-4655
Practice Address - Country:US
Practice Address - Phone:316-721-5000
Practice Address - Fax:316-721-6604
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0517721207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine