Basic Information
| Provider Information | |||||||||
| NPI: | 1164889630 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CANCER CENTER OF KANSAS, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 818 N. EMPORIA | ||||||||
| Address2: | SUITE 403 | ||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672143728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3162624467 | ||||||||
| FaxNumber: | 3162620706 | ||||||||
| Practice Location | |||||||||
| Address1: | 2600 OTTAWA RD | ||||||||
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| City: | NEODESHA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 667571897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6203258353 | ||||||||
| FaxNumber: | 3162620706 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/28/2016 | ||||||||
| LastUpdateDate: | 01/30/2016 | ||||||||
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| AuthorizedOfficialLastName: | HADSELL | ||||||||
| AuthorizedOfficialFirstName: | ANNIE | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | BUSINESS OFFICE SUPERVISOR | ||||||||
| AuthorizedOfficialTelephone: | 3166134296 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.