Healthcare Provider Details

I. General information

NPI: 1487613790
Provider Name (Legal Business Name): KANSAS SURGICAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 S MOUNT CARMEL PL
PITTSBURG KS
66762-6604
US

IV. Provider business mailing address

1011 S MOUNT CARMEL PL
PITTSBURG KS
66762-6604
US

V. Phone/Fax

Practice location:
  • Phone: 620-231-6160
  • Fax: 620-235-0175
Mailing address:
  • Phone: 620-231-6160
  • Fax: 620-235-0175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT STEPHEN HUEBNER
Title or Position: OWNER
Credential: MD
Phone: 620-231-6160