Provider Demographics
NPI:1790112894
Name:KATHLEEN CAIN MD PA
Entity Type:Organization
Organization Name:KATHLEEN CAIN MD PA
Other - Org Name:KIDS FIRST PEDIATRIC URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-273-4165
Mailing Address - Street 1:6750 SW 29TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-5648
Mailing Address - Country:US
Mailing Address - Phone:785-273-4165
Mailing Address - Fax:785-271-4149
Practice Address - Street 1:6750 SW 29TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-5648
Practice Address - Country:US
Practice Address - Phone:785-273-4165
Practice Address - Fax:785-271-4149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0426358208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100282110CMedicaid