Provider Demographics
NPI:1760479240
Name:KANSAL, SUKESH KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SUKESH
Middle Name:KUMAR
Last Name:KANSAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1499 E IRON AVE
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3233
Mailing Address - Country:US
Mailing Address - Phone:785-825-2003
Mailing Address - Fax:785-825-2015
Practice Address - Street 1:1499 E IRON AVE
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3233
Practice Address - Country:US
Practice Address - Phone:785-825-2003
Practice Address - Fax:785-825-2015
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0430169207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00156354OtherRAILROAD MEDICARE PROV
KSP00156354OtherRAILROAD MEDICARE PROV
KS104029Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER