Provider Demographics
NPI:1053457978
Name:KANSAS UNIVERSITY PHYSICIANS INC
Entity Type:Organization
Organization Name:KANSAS UNIVERSITY PHYSICIANS INC
Other - Org Name:KU OBSTETRIC & GYNECOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEPARTMENT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-588-2500
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:4070 DELP MAIL STOP 4017
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160
Mailing Address - Country:US
Mailing Address - Phone:913-588-2500
Mailing Address - Fax:
Practice Address - Street 1:G013 WAHL EAST KU MEDICAL CENTER
Practice Address - Street 2:MAIL STOP 2028 3901 RAINBOW BLVD
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KANSAS UNIVERSITY PHYSICIANS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-29
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
No207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO01812031OtherBCBS KC GRP NUMBER
MO500567805Medicaid
KS100217430MMedicaid
KS026152OtherBCBS KS GRP NUMBER
CC8801Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MO500567805Medicaid