Healthcare Provider Details

I. General information

NPI: 1497592802
Provider Name (Legal Business Name): DOCTOR ON DEMAND PROFESSIONALS OF KANSAS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CALIFORNIA ST STE 2300
SAN FRANCISCO CA
94111-5424
US

IV. Provider business mailing address

1 CALIFORNIA ST STE 2300
SAN FRANCISCO CA
94111-5424
US

V. Phone/Fax

Practice location:
  • Phone: 800-997-6196
  • Fax: 833-523-9924
Mailing address:
  • Phone: 800-997-6196
  • Fax: 833-523-9924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: TODD ANDREW THAMES
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 800-997-6196