Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Age Reversal Technologies

Organization Family Medicine Physician · NPI 1841594892

Age Reversal Technologies is a Family Medicine Physician 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
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