Provider Demographics
NPI:1649568973
Name:ROUSE, MICHAEL TAYLOR (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:TAYLOR
Last Name:ROUSE
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Gender:M
Credentials:DO
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Mailing Address - Street 1:KANSAS UNIVERSITY PHYSICIANS, INC.
Mailing Address - Street 2:3901 RAINBOW BLVD. 4070 DELP, MS 4017
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:913-588-2501
Mailing Address - Fax:913-588-3877
Practice Address - Street 1:DIVISION OF GENERAL AND GERIATRIC MEDICINE, UNIVERSITY
Practice Address - Street 2:3901 RAINBOW BLVD. 6040 DELP, MS 1020
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-6005
Practice Address - Fax:913-588-3877
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
KS05-37277207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine