Provider Demographics
NPI:1891773065
Name:VORA, MEHBOOB I (DO)
Entity Type:Individual
Prefix:DR
First Name:MEHBOOB
Middle Name:I
Last Name:VORA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 N DUBLIN CIR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-1841
Mailing Address - Country:US
Mailing Address - Phone:316-655-3941
Mailing Address - Fax:
Practice Address - Street 1:2633 N. DUBLIN CIRCLE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226
Practice Address - Country:US
Practice Address - Phone:316-655-3941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-25872207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100236500DMedicaid
KS102672OtherBLUE SHIELD KS
KS100236500DMedicaid
KSF88048Medicare UPIN
KS102672Medicare PIN
KS111178Medicare PIN
KS110871Medicare PIN