Healthcare Provider Details

I. General information

NPI: 1417940313
Provider Name (Legal Business Name): BHARATA LANKACHANDRA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BHARATA KADUPITIGE ARYARATNA LANKACHANDRA M.B.B.S.

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 08/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10500 QUIVIRA RD
OVERLAND PARK KS
66215-2306
US

IV. Provider business mailing address

10901 GRANADA LN #200
OVERLAND PARK KS
66211-1401
US

V. Phone/Fax

Practice location:
  • Phone: 913-541-5000
  • Fax:
Mailing address:
  • Phone: 913-660-1616
  • Fax: 913-660-1664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number106838
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number04-26655
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: