Provider Demographics
NPI:1205905726
Name:ZERGER, BRIAN S (PA-C)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:S
Last Name:ZERGER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:10100 SHANNON WOODS
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226
Mailing Address - Country:US
Mailing Address - Phone:316-858-1900
Mailing Address - Fax:316-858-1914
Practice Address - Street 1:1923 N WEBB RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3405
Practice Address - Country:US
Practice Address - Phone:316-262-4886
Practice Address - Fax:316-262-4887
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-01426363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS311810056OtherTAX ID