Provider Demographics
NPI:1184629933
Name:TOPEKA ALLERGY & ASTHMA CLINIC, P.A.
Entity Type:Organization
Organization Name:TOPEKA ALLERGY & ASTHMA CLINIC, P.A.
Other - Org Name:TOPEKA ALLERGY CLINIC, P.A.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTICE ADMIN/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TORRI
Authorized Official - Middle Name:
Authorized Official - Last Name:NOBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-273-9999
Mailing Address - Street 1:1123 SW GAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-1774
Mailing Address - Country:US
Mailing Address - Phone:785-273-9999
Mailing Address - Fax:
Practice Address - Street 1:1123 SW GAGE BLVD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-1774
Practice Address - Country:US
Practice Address - Phone:785-273-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-17
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100217480AMedicaid
KS016445Medicare PIN
KS100217480AMedicaid