Provider Demographics
NPI:1801011184
Name:CHASE, SEGEN ELIZABETH SMITH (MD)
Entity Type:Individual
Prefix:MRS
First Name:SEGEN ELIZABETH
Middle Name:SMITH
Last Name:CHASE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SEGEN ELIZABETH
Other - Middle Name:SMITH
Other - Last Name:CHASE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1133 COLLEGE AVE
Mailing Address - Street 2:STE D200
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2776
Mailing Address - Country:US
Mailing Address - Phone:785-537-4940
Mailing Address - Fax:785-537-0836
Practice Address - Street 1:3260 KIMBALL AVENUE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-2157
Practice Address - Country:US
Practice Address - Phone:402-559-7268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NET5055207R00000X
KS04-32324207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200437010AMedicaid
KS106419Medicare PIN