Provider Demographics
NPI:1952527442
Name:BHARGAVA, TARUN (MD)
Entity type:Individual
Prefix:
First Name:TARUN
Middle Name:
Last Name:BHARGAVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1923 N WEBB RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3405
Mailing Address - Country:US
Mailing Address - Phone:316-262-4886
Mailing Address - Fax:316-262-4887
Practice Address - Street 1:1923 N WEBB RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3405
Practice Address - Country:US
Practice Address - Phone:316-262-4886
Practice Address - Fax:316-262-4887
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0430804207X00000X
KS04-30804207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0000107289OtherBLUE CROSS AND BLUE SHIELD
KS200565910DMedicaid
KS17286OtherPREFERRED HEALTH SYSTEMS
KA1295028Medicare PIN