Healthcare Provider Details

I. General information

NPI: 1609185693
Provider Name (Legal Business Name): PAUL A KUSY O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2010
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5321 SW TIMBER RIDGE LN
TOPEKA KS
66610-1267
US

IV. Provider business mailing address

5321 SW TIMBER RIDGE LN
TOPEKA KS
66610-1267
US

V. Phone/Fax

Practice location:
  • Phone: 937-477-1565
  • Fax:
Mailing address:
  • Phone: 937-477-1565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberKS1966
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number13686 T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: