Basic Information
| Provider Information | |||||||||
| NPI: | 1396879946 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TOPEKA NEUROLOGY ASSOCIATES, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 631 SW HORNE ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666061694 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852346300 | ||||||||
| FaxNumber: | 7852346301 | ||||||||
| Practice Location | |||||||||
| Address1: | 631 SW HORNE ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666061694 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852346300 | ||||||||
| FaxNumber: | 7852346301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2007 | ||||||||
| LastUpdateDate: | 05/21/2010 | ||||||||
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| AuthorizedOfficialLastName: | WELCH | ||||||||
| AuthorizedOfficialFirstName: | WADE | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7852346300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 04-24326 | KS | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 100143760B | 05 | KS | MEDICAID |