George Stephen Granberry IV, PA-C
Physician Assistant in Wichita, KS. Individual provider (NPI-1).
NPI number1679910285
StatusActive
Last updated in NPPESMar 17, 2026
Details
- NPI
- 1679910285
- Entity type
- Individual (NPI-1)
- Name
- George Stephen Granberry IV
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 23, 2013
- Certification date
- Mar 17, 2026
- Last updated
- Mar 17, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 15-01611 | KS | Yes |
Practice location
9828 E Shannon Woods Cir Ste 100Wichita, KS 67226-4100
Phone 316-631-1600 · Fax 316-631-1617
Mailing address
9828 E Shannon Woods Cir Ste 100Wichita, KS 67226-4100
Phone 316-631-1600 · Fax 316-631-1617
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