Medical school: UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated: 1972
NPI: 1083619555
Practice Locations (3)
419 FUKKER RD
DOTHAN, AL 363019000
5555 W 58TH ST
MISSION, KS 662022722
PO BOX, SUITE 9066
MISSION, KS 662011666
Source: CMS National Downloadable File, September 2026.