Provider Demographics
NPI:1952353740
Name:KRESIE & PENZLER, M.D.'S PA
Entity type:Organization
Organization Name:KRESIE & PENZLER, M.D.'S PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-233-0011
Mailing Address - Street 1:6001 SW 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66615-1004
Mailing Address - Country:US
Mailing Address - Phone:785-233-0011
Mailing Address - Fax:785-233-1292
Practice Address - Street 1:6001 SW 6TH AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-1004
Practice Address - Country:US
Practice Address - Phone:785-233-0011
Practice Address - Fax:785-233-1292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110949Medicare ID - Type UnspecifiedGROUP ID NUMBER