Provider Demographics
NPI:1851368344
Name:KANSAS SLEEP & BREATHING CLINIC, PA
Entity Type:Organization
Organization Name:KANSAS SLEEP & BREATHING CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TED
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:DAUGHETY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-232-0109
Mailing Address - Street 1:634 SW HORNE ST
Mailing Address - Street 2:SUITE 410
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1652
Mailing Address - Country:US
Mailing Address - Phone:785-232-0109
Mailing Address - Fax:785-232-4748
Practice Address - Street 1:634 SW HORNE ST
Practice Address - Street 2:SUITE 410
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1652
Practice Address - Country:US
Practice Address - Phone:785-232-0109
Practice Address - Fax:785-232-4748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS21292207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSB69126Medicare UPIN
KS111192Medicare ID - Type Unspecified