Provider Demographics
NPI:1164423950
Name:CULVER, SONYA K (DO)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:K
Last Name:CULVER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 KATY AVE
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:KS
Mailing Address - Zip Code:67357-2451
Mailing Address - Country:US
Mailing Address - Phone:620-421-2700
Mailing Address - Fax:620-421-8135
Practice Address - Street 1:1902 S US HIGHWAY 59
Practice Address - Street 2:STE 4
Practice Address - City:PARSONS
Practice Address - State:KS
Practice Address - Zip Code:67357-4948
Practice Address - Country:US
Practice Address - Phone:620-421-2700
Practice Address - Fax:620-421-8135
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-21956207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100236200BMedicaid
KS53091OtherBCBS
KS53091Medicare ID - Type Unspecified
KS100236200BMedicaid