Provider Demographics
NPI:1063491322
Name:CHINBURG, PAUL K (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:K
Last Name:CHINBURG
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 488
Mailing Address - Street 2:
Mailing Address - City:DIGHTON
Mailing Address - State:KS
Mailing Address - Zip Code:67839-0488
Mailing Address - Country:US
Mailing Address - Phone:620-397-5316
Mailing Address - Fax:620-397-2264
Practice Address - Street 1:444 WEST LONG ST.
Practice Address - Street 2:
Practice Address - City:DIGHTON
Practice Address - State:KS
Practice Address - Zip Code:67839-0488
Practice Address - Country:US
Practice Address - Phone:620-397-5316
Practice Address - Fax:620-397-2264
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-20255208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS04-20255OtherKS LICENCE #
KS100124010CMedicaid
KS100124010CMedicaid
KS04-20255OtherKS LICENCE #
KSAC1864683OtherDEA #