Provider Demographics
NPI:1053316612
Name:KAINE, LOUISE M (DO)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:M
Last Name:KAINE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 W 58TH ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-2722
Mailing Address - Country:US
Mailing Address - Phone:913-676-6120
Mailing Address - Fax:913-432-8463
Practice Address - Street 1:8800 W 75TH ST
Practice Address - Street 2:STE 300
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-4001
Practice Address - Country:US
Practice Address - Phone:913-722-4240
Practice Address - Fax:913-722-2435
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0526698207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSF209846Medicare PIN
KSG46137Medicare UPIN
KSF200000Medicare PIN