Healthcare Provider Details

I. General information

NPI: 1427011907
Provider Name (Legal Business Name): PATHOLOGY SERVICES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 11/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5650 SW 29TH STREET
TOPEKA KS
66614-2443
US

IV. Provider business mailing address

5650 SW 29TH STREET
TOPEKA KS
66614-2443
US

V. Phone/Fax

Practice location:
  • Phone: 785-272-4783
  • Fax: 785-272-4783
Mailing address:
  • Phone: 785-272-4783
  • Fax: 785-272-4783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number0415028
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number0415028
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number0415028
License Number StateKS

VIII. Authorized Official

Name: DR. DAVID M BOREL
Title or Position: PRESIDENT MEDICAL DIRECTOR
Credential: MD
Phone: 785-272-4783