Healthcare Provider Details

I. General information

NPI: 1144545773
Provider Name (Legal Business Name): TOBIAS BENJAMIN KULIK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 WORNALL RD
KANSAS CITY MO
64111-3241
US

IV. Provider business mailing address

100 SUN AVE NE STE 650
ALBUQUERQUE NM
87109-4670
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-2261
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD2016-0727
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberFK4917918
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License NumberMD2016-0727
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number178106
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2014004998
License Number StateMO
# 6
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number2014004998
License Number StateMO
# 7
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD487368C
License Number StatePA
# 8
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number2026-00621
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: