Glenn Darrell Bauman, DC

Individual provider Active NPI Chiropractor · Garnett, KS

NPI 1801901491 · NPPES record last updated Sep 28, 2012

Key facts

NPI
1801901491
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
0104979 (KS)
Practice address
519 S Maple
Garnett, KS 66032-1427
Phone
(785) 448-2422
Fax
(785) 448-2427
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
0104979KSMDChiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104979 KS Yes

Addresses

Primary practice location

519 S Maple
Garnett, KS 66032-1427

Mailing address

519 S Maple
Garnett, KS 66032-1427
Phone (785) 448-2422

Other identifiers

IdentifierTypeStateIssuer
7005674OtherKSAETNA
062219OtherKSBCBS

Other providers in Garnett, KS

All providers in Garnett, KS · Chiropractor in Kansas

Sources for this page

Verify at the official NPI Registry.