Healthcare Provider Details

I. General information

NPI: 1205825825
Provider Name (Legal Business Name): DONALD E BANKS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 06/14/2022
Certification Date: 06/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 BAPTISTE DR STE A
PAOLA KS
66071-1888
US

IV. Provider business mailing address

1401 BAPTISTE DR STE A
PAOLA KS
66071-1888
US

V. Phone/Fax

Practice location:
  • Phone: 913-294-2305
  • Fax: 913-294-3144
Mailing address:
  • Phone: 913-294-2305
  • Fax: 913-294-3144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number422796
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: