Provider Demographics
NPI:1710950746
Name:TATPATI, OLGA A (MD)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:A
Last Name:TATPATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 S CLIFTON AVE
Mailing Address - Street 2:SUITE 460
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-2900
Mailing Address - Country:US
Mailing Address - Phone:316-689-6803
Mailing Address - Fax:316-689-0818
Practice Address - Street 1:1515 S CLIFTON AVE
Practice Address - Street 2:SUITE 460
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-2900
Practice Address - Country:US
Practice Address - Phone:316-689-6803
Practice Address - Fax:316-689-0818
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSB68169Medicare UPIN
KS101393Medicare ID - Type Unspecified