Gillenwater, David
Gillenwater, David is an individual health care provider with primary practice located at 3515 Broadway Ave , Great Bend KS 67530-3633. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Gillenwater, David can be contacted via phone (620) 792-2511.Contact Information
Primary practice address
3515 Broadway Ave
Great Bend KS 67530-3633
Phone: (620) 792-2511
Fax: (316) 652-0340
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 0421903 | Kansas |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207LA0401X | 0421903 | Kansas |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207LC0200X | 0421903 | Kansas |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 0421903 | Kansas |
Profile Details
| NPI number | 1427026384 |
|---|---|
| LBN Legal business name | Gillenwater, David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 8th, 2006 |
| Last updated | Jun 3rd, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427026384 | NPPES |
| Kansas | Other | 045282 | BCBS |
| Kansas | Other | 050022332 | BCBS |
| Kansas | MEDICAID | 100142910A | BCBS |
| Kansas | Other | 481129529 | BCBS |
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