Provider Demographics
NPI:1255377958
Name:NEUBAUER, KAREN E (DO)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:E
Last Name:NEUBAUER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11550 GRANADA LN
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1453
Mailing Address - Country:US
Mailing Address - Phone:913-451-7546
Mailing Address - Fax:913-663-2422
Practice Address - Street 1:11550 GRANADA LN
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1453
Practice Address - Country:US
Practice Address - Phone:913-451-7546
Practice Address - Fax:913-663-2422
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004016560207N00000X
KS530781207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G30797Medicare UPIN
G30797Medicare UPIN