| Mr Carl Lee Green, PA | |
|
750 W D Ave, Kingman, KS 67068-1266 | |
| (620) 532-3147 | |
| Not Available |
| Full Name | Mr Carl Lee Green |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 750 W D Ave, Kingman, Kansas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619935335 | NPI | - | NPPES |
| 042639 | Other | KS | BLUE CROSS/BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 1500576 (Kansas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Carl Lee Green, PA 1015 N Firefly Cir, Wichita, KS 67235-9437 Ph: (316) 721-5284 | Mr Carl Lee Green, PA 750 W D Ave, Kingman, KS 67068-1266 Ph: (620) 532-3147 |
Tyler J Antenen, P.A.-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 750 W D Ave, Kingman, KS 67068 Phone: 620-532-0295 Fax: 855-483-0002 | |
Mr. Jeffery Leonard Henderson, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 701 E A Ave, Kingman, KS 67068 Phone: 620-532-5145 Fax: 620-532-2586 | |
Dennis Kalmar, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 750 W D Ave, Kingman, KS 67068 Phone: 620-532-0295 Fax: 855-483-0002 | |
Paul Halderson, Physician Assistant Medicare: Medicare Enrolled Practice Location: 750 W D Ave, Kingman, KS 67068 Phone: 620-532-3147 Fax: 620-532-0167 | |
Kathryn A Kimpler, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 701 E A Ave, Kingman, KS 67068 Phone: 620-532-5145 Fax: 620-532-2478 | |
Mr. Leroy E Shugart, P.A. Physician Assistant Medicare: Medicare Enrolled Practice Location: 750 W D Ave, Kingman, KS 67068 Phone: 620-532-3147 Fax: 620-532-3147 |