Provider Demographics
NPI:1962503797
Name:BINGLE, JANICE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:MARIE
Last Name:BINGLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4021 W 26TH TER
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-2661
Mailing Address - Country:US
Mailing Address - Phone:785-221-3301
Mailing Address - Fax:
Practice Address - Street 1:325 SW FRAZIER AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1963
Practice Address - Country:US
Practice Address - Phone:785-232-5005
Practice Address - Fax:785-232-0160
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-265052084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100167080AMedicaid
KSF93716Medicare UPIN
KS100167080AMedicaid