Northeast Kansas Gi Consultants Pa | |
3601 S 4th St Suite 5 Leavenworth KS 66048-5015 | |
(913) 220-5193 | |
(913) 814-9989 |
Full Name | Northeast Kansas Gi Consultants Pa |
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Speciality | Internal Medicine |
Location | 3601 S 4th St, Leavenworth, Kansas |
Authorized Official Name and Position | Srinivasa Rao G. Vasa (OWNER) |
Authorized Official Contact | 9132205193 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Northeast Kansas Gi Consultants Pa 3601 S 4th St Suite 5 Leavenworth KS 66048-5015 Ph: (913) 220-5193 | Northeast Kansas Gi Consultants Pa 3601 S 4th St Suite 5 Leavenworth KS 66048-5015 Ph: (913) 220-5193 |
NPI Number | 1326080755 |
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Provider Enumeration Date | 06/11/2006 |
Last Update Date | 03/26/2014 |
Medicare PECOS PAC ID | 5294791125 |
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Medicare Enrollment ID | O20041202000761 |
Identifier | Type | State | Issuer |
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1326080755 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207RG0100X | Internal Medicine - Gastroenterology | 04-27796 (Kansas) | Primary |
Provider Name | Srinivasa Rao G Vasa |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1457398190 PECOS PAC ID: 8123011061 Enrollment ID: I20041203000224 |
Occupational & Preventive Medicine Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 920 6th Ave, Medical Arts Building, Leavenworth, KS 66048 Phone: 913-682-7225 Fax: 913-651-2007 | |
Medical Arts Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3601 S 4th St, Leavenworth, KS 66048 Phone: 913-682-2600 | |