Provider Demographics
NPI:1740288463
Name:DEBIASSE, DEBRA J (MD)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:J
Last Name:DEBIASSE
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 1:737 E CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-5103
Mailing Address - Country:US
Mailing Address - Phone:785-827-7261
Mailing Address - Fax:785-827-6334
Practice Address - Street 1:737 E CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-5103
Practice Address - Country:US
Practice Address - Phone:785-827-7261
Practice Address - Fax:785-827-6334
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04/23338208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100121750BMedicaid
KS020077Medicare ID - Type Unspecified
KSE56743Medicare UPIN