Healthcare Provider Details

I. General information

NPI: 1346386265
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: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 RAINBOW BLVD MS 3010
KANSAS CITY KS
66160
US

IV. Provider business mailing address

3901 RAINBOW BLVD MS 3010
KANSAS CITY KS
66160
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6731
  • Fax: 913-588-0107
Mailing address:
  • Phone: 913-588-6701
  • Fax: 913-588-0107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: MIKE EDWARDS
Title or Position: DEPARTMENT ADMINISTRATOR
Credential:
Phone: 913-588-6728