Healthcare Provider Details

I. General information

NPI: 1053457978
Provider Name (Legal Business Name): KANSAS UNIVERSITY PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

G013 WAHL EAST KU MEDICAL CENTER MAIL STOP 2028 3901 RAINBOW BLVD
KANSAS CITY KS
66160
US

IV. Provider business mailing address

3901 RAINBOW BLVD 4070 DELP MAIL STOP 4017
KANSAS CITY KS
66160
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-2500
  • Fax:
Mailing address:
  • Phone: 913-588-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DON BRANSON
Title or Position: DEPARTMENT ADMINISTRATOR
Credential:
Phone: 913-588-2500