Provider Demographics
NPI:1205825825
Name:BANKS, DONALD E (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:E
Last Name:BANKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1401 BAPTISTE DR STE A
Mailing Address - Street 2:
Mailing Address - City:PAOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66071-1888
Mailing Address - Country:US
Mailing Address - Phone:913-294-2305
Mailing Address - Fax:913-294-3144
Practice Address - Street 1:1401 BAPTISTE DR STE A
Practice Address - Street 2:
Practice Address - City:PAOLA
Practice Address - State:KS
Practice Address - Zip Code:66071-1888
Practice Address - Country:US
Practice Address - Phone:913-294-2305
Practice Address - Fax:913-294-3144
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS422796207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100123610AMedicaid
E80878Medicare UPIN
KS020546Medicare PIN