Provider Demographics
NPI:1720198211
Name:CENTER FOR SIGHT OF NORTHEAST KANSAS, PA
Entity Type:Organization
Organization Name:CENTER FOR SIGHT OF NORTHEAST KANSAS, PA
Other - Org Name:HEARTLAND EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-235-3322
Mailing Address - Street 1:619 SW CORPORATE VIEW
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66615-1233
Mailing Address - Country:US
Mailing Address - Phone:785-235-3322
Mailing Address - Fax:785-246-6258
Practice Address - Street 1:619 SW CORPORATE VIEW
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-1233
Practice Address - Country:US
Practice Address - Phone:785-235-3322
Practice Address - Fax:785-246-6258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSCD6151OtherPALMETTO GBA
KS110291OtherBCBS OF KS
KS110291Medicare PIN
KSCD6151OtherPALMETTO GBA