Provider Demographics
NPI:1164524286
Name:VARGHESE, GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:VARGHESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:M.
Other - Middle Name:GEORGE
Other - Last Name:VARGHESE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:4017 DELP
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:913-588-6944
Mailing Address - Fax:913-588-6765
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:G018 MURPHY MAILSTOP 1046
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-6944
Practice Address - Fax:913-588-6765
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-17093208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO06794046OtherBCBS KANSAS CITY
KS627300OtherFIRSTGUARD
3543720AMedicare ID - Type Unspecified
KS627300OtherFIRSTGUARD