Provider Demographics
NPI:1356303028
Name:STRANATHAN, SIDNEY W (DO)
Entity Type:Individual
Prefix:
First Name:SIDNEY
Middle Name:W
Last Name:STRANATHAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 EAST SPRING
Mailing Address - Street 2:
Mailing Address - City:ANTHONY
Mailing Address - State:KS
Mailing Address - Zip Code:67003-2122
Mailing Address - Country:US
Mailing Address - Phone:620-842-5144
Mailing Address - Fax:
Practice Address - Street 1:1101 EAST SPRING
Practice Address - Street 2:
Practice Address - City:ANTHONY
Practice Address - State:KS
Practice Address - Zip Code:67003-2122
Practice Address - Country:US
Practice Address - Phone:620-842-5144
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0518991208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100229370CMedicaid
KSH13197Medicare UPIN