Healthcare Provider Details

I. General information

NPI: 1164438396
Provider Name (Legal Business Name): LOUIS PAUL MENG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: NA NA NA MD

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 03/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 COLLEGE AVE BUILDING G, SUITE 210
MANHATTAN KS
66502-2770
US

IV. Provider business mailing address

1607 LITTLE KITTEN AVE
MANHATTAN KS
66503-7543
US

V. Phone/Fax

Practice location:
  • Phone: 785-537-9030
  • Fax:
Mailing address:
  • Phone: 785-537-0887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2003014165
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number04 36867
License Number StateKS

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier201087320A
Identifier TypeMEDICAID
Identifier StateKS
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: