Provider Demographics
NPI:1750459657
Name:KANSAS UNIVERSITY PHYSICIANS INC
Entity Type:Organization
Organization Name:KANSAS UNIVERSITY PHYSICIANS INC
Other - Org Name:KU ANESTHESIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEPARTMENT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:ORNDOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-588-3305
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:4070 DELP MAIL STOP 4017
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-7415
Mailing Address - Country:US
Mailing Address - Phone:913-588-6670
Mailing Address - Fax:
Practice Address - Street 1:2467 KU HOSPITAL
Practice Address - Street 2:MAIL STOP 1034 3901 RAINBOW BLVD
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-7415
Practice Address - Country:US
Practice Address - Phone:913-588-6670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KANSAS UNIVERSITY PHYSICIANS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-01
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS076631OtherBCBS KS GROUP NUMBER
CC8801OtherRR MEDICARE GROUP NUMBER
1094420001OtherDMERC PROVIDER NUMBER
KS100217430GMedicaid
MO542174701Medicaid
MO09364025OtherBCBS KC GROUP NUMBER
KS100217430GMedicaid