1306872023 NPI number — UNIVERSITY OF KANSAS MEDICAL CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306872023 NPI number — UNIVERSITY OF KANSAS MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF KANSAS MEDICAL CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306872023
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3901 RAINBOW BLVD
Provider Second Line Business Mailing Address:
6018 WAHL HALL EAST, MS 3018
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66160-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-588-9252
Provider Business Mailing Address Fax Number:
913-588-9251

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3901 RAINBOW BLVD
Provider Second Line Business Practice Location Address:
6018 WAHL HALL EAST, MS 3018
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66160-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-588-9252
Provider Business Practice Location Address Fax Number:
913-588-9251
Provider Enumeration Date:
06/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
QUARLES
Authorized Official First Name:
LEIGH
Authorized Official Middle Name:
DARRYL
Authorized Official Title or Position:
PROFESSOR
Authorized Official Telephone Number:
913-588-9252

Provider Taxonomy Codes

  • Taxonomy code: 281P00000X , with the licence number:  04-30604 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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