Provider Demographics
NPI:1164610291
Name:DONALD E. BANKS
Entity Type:Organization
Organization Name:DONALD E. BANKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERRIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-294-2305
Mailing Address - Street 1:PO BOX 298
Mailing Address - Street 2:
Mailing Address - City:PAOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66071-0298
Mailing Address - Country:US
Mailing Address - Phone:913-294-2305
Mailing Address - Fax:913-294-5403
Practice Address - Street 1:705 BAPTISTE DR
Practice Address - Street 2:
Practice Address - City:PAOLA
Practice Address - State:KS
Practice Address - Zip Code:66071-1336
Practice Address - Country:US
Practice Address - Phone:913-294-2305
Practice Address - Fax:913-294-5403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS422796207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS17458011OtherMISSOURI BLUE SHIELD
KS1205825825OtherNPI
KS20546OtherKANSAS BLUE SHIELD
KS621111OtherNAICS
KS422796OtherSTATE LICENSE
KS422796OtherSTATE LICENSE
KS1205825825OtherNPI
KS17458011OtherMISSOURI BLUE SHIELD
KSE80878Medicare UPIN