Provider Demographics
NPI:1922144856
Name:KANSAS UNIVERSITY PHYSICIANS INC
Entity Type:Organization
Organization Name:KANSAS UNIVERSITY PHYSICIANS INC
Other - Org Name:KU NEUROSURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEPARTMENT ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:KARASEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-588-6122
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:4070 DELP MAIL STOP 4017
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160
Mailing Address - Country:US
Mailing Address - Phone:913-588-6122
Mailing Address - Fax:
Practice Address - Street 1:5040 SUDLER HALL
Practice Address - Street 2:MAIL STOP 3021 3901 RAINBOW BLVD
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-6122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KANSAS UNIVERSITY PHYSICIANS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-29
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100088160BMedicaid
KS026986OtherBCBS KS GRP NUMBER
MO501442008Medicaid
MO38289012OtherBLUE CROSS BLUE SHIELD OF KANSAS CITY
KS026986OtherBCBS KS GRP NUMBER
MO38289012OtherBLUE CROSS BLUE SHIELD OF KANSAS CITY