Provider Demographics
NPI:1578232914
Name:QUIT GENIUS MEDICAL OF KANSAS, P.A.
Entity Type:Organization
Organization Name:QUIT GENIUS MEDICAL OF KANSAS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHET
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:THARPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-559-6188
Mailing Address - Street 1:1732 1ST AVE STE 20163
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5177
Mailing Address - Country:US
Mailing Address - Phone:601-559-6188
Mailing Address - Fax:
Practice Address - Street 1:2101 SW 21ST ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3174
Practice Address - Country:US
Practice Address - Phone:601-559-6188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS5455423OtherKS SECRETARY OF STATE - ARTICLES OF INCORPORATION