Provider Demographics
NPI:1699334383
Name:SAAVEDRA, DIEGO A (PA)
Entity type:Individual
Prefix:
First Name:DIEGO
Middle Name:A
Last Name:SAAVEDRA
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5157 N COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:BEL AIRE
Mailing Address - State:KS
Mailing Address - Zip Code:67226-7620
Mailing Address - Country:US
Mailing Address - Phone:620-271-2125
Mailing Address - Fax:
Practice Address - Street 1:293 S GREENWICH RD
Practice Address - Street 2:SUITE 300
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-6720
Practice Address - Country:US
Practice Address - Phone:316-517-4000
Practice Address - Fax:316-515-5110
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-02251363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant