Provider Demographics
NPI:1073738233
Name:KOBES, KEITH JACOB (PHD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:JACOB
Last Name:KOBES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10465 S MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-2777
Mailing Address - Country:US
Mailing Address - Phone:913-220-8448
Mailing Address - Fax:913-345-0177
Practice Address - Street 1:8575 W. 110TH ST
Practice Address - Street 2:218
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2620
Practice Address - Country:US
Practice Address - Phone:913-345-0033
Practice Address - Fax:913-345-0177
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS878103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist