Provider Demographics
NPI:1801838396
Name:KOVARIK, ERNEST D (MD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:D
Last Name:KOVARIK
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 1:6001 SW 6TH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66615-1011
Mailing Address - Country:US
Mailing Address - Phone:785-271-2200
Mailing Address - Fax:785-271-2219
Practice Address - Street 1:6001 SW 6TH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-1011
Practice Address - Country:US
Practice Address - Phone:785-271-2200
Practice Address - Fax:785-271-2219
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0414640174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS105281OtherBLUE CROSS BLUE SHIELD OF
KSP00321355OtherRAILROAD MEDICARE
KSP00321355OtherRAILROAD MEDICARE
B68241Medicare UPIN