Provider Demographics
NPI:1437251964
Name:PARHAM, VERDON W (MD)
Entity type:Individual
Prefix:
First Name:VERDON
Middle Name:W
Last Name:PARHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 426
Mailing Address - Street 2:
Mailing Address - City:CHANUTE
Mailing Address - State:KS
Mailing Address - Zip Code:66720-0426
Mailing Address - Country:US
Mailing Address - Phone:620-432-5588
Mailing Address - Fax:620-431-1192
Practice Address - Street 1:1501 W 7TH ST
Practice Address - Street 2:
Practice Address - City:CHANUTE
Practice Address - State:KS
Practice Address - Zip Code:66720-2551
Practice Address - Country:US
Practice Address - Phone:620-432-5588
Practice Address - Fax:620-431-1192
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-16083207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS17-8977OtherMEDICARE PART A RURAL HEALTH CLINIC
KS100082510DMedicaid
KS203609319OtherCIGNA
KS660370OtherFIRSTGUARD
KSP00274846OtherRAILROAD MEDICARE
KS5046043OtherAETNA
KS301043OtherHEALTH PARTNER OF KANSAS
KS105182OtherBLUE CROSS BLUE SHIELD
KS17-8977OtherMEDICARE PART A RURAL HEALTH CLINIC
KSB68376Medicare UPIN