Provider Demographics
NPI:1659330801
Name:LENAHAN, ROBERT KEVIN (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:KEVIN
Last Name:LENAHAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4365
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-0365
Mailing Address - Country:US
Mailing Address - Phone:785-354-8383
Mailing Address - Fax:785-354-8386
Practice Address - Street 1:2008 SW GAGE BLVD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3340
Practice Address - Country:US
Practice Address - Phone:785-354-8383
Practice Address - Fax:785-354-8386
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1355152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSRL17001OtherSPECTERA
KS24309024OtherBCBS OF KANSAS CITY
KS650735Medicare ID - Type Unspecified
KS24309024OtherBCBS OF KANSAS CITY
KSU20123Medicare UPIN
KS4183660002Medicare NSC