Provider Demographics
NPI:1467403923
Name:WEEKS, KERRI L (MD)
Entity Type:Individual
Prefix:DR
First Name:KERRI
Middle Name:L
Last Name:WEEKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KERRI
Other - Middle Name:L
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:620 N CARRIAGE PKWY
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-4501
Mailing Address - Country:US
Mailing Address - Phone:316-962-3100
Mailing Address - Fax:316-962-3192
Practice Address - Street 1:620 N CARRIAGE PKWY
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-4501
Practice Address - Country:US
Practice Address - Phone:316-962-3100
Practice Address - Fax:316-962-3192
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004014095208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0431639OtherSTATE LISENCE NUMBER
MO2004014095OtherSTATE LISENCE NUMBER
KS200376410DMedicaid