Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Age Reversal Technologies

Organization Family Medicine Physician · NPI 1841594892

Age Reversal Technologies provides Family Medicine Physician services in Wichita, Kansas. Licensed in Kansas. Registered with an NPI since 2011.

Licensed in
KS
In the registry since
2011
Specialties on file
2

Practice location Address checks out

2600 N Woodlawn Blvd
Wichita, KS 67220-2729 Not confirmed with CMS for 15 years — call before visiting
Phone: (316) 640-6253
Fax: (316) 858-2523
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 15-00115 (KS)
Internal Medicine Physician Taxonomy 207R00000X · Licence 15-00115 (KS)

Record details

NPI number1841594892
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Shaw — Owner/President · (316) 640-6253
NPI enumeratedJanuary 5, 2011
Last updated in NPPESSeptember 30, 2011
Mailing address2600 N Woodlawn Blvd, Wichita, KS 67220-2729

Other providers in Wichita