Basic Information
| Provider Information | |||||||||
| NPI: | 1427168046 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PORTER-WILLIAMSON | ||||||||
| FirstName: | KARIN | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | UNIVERSITY OF KANSAS PHYSICIANS INC | ||||||||
| Address2: | 3901 RAINBOW BLVD, 4070 DELP, MS 4017 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661600001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135882500 | ||||||||
| FaxNumber: | 9139456789 | ||||||||
| Practice Location | |||||||||
| Address1: | KU MEDICAL CENTER DIV OF GEN MEDICINE | ||||||||
| Address2: | 3901 RAINBOW BLVD, MS 1020 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661600001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135886005 | ||||||||
| FaxNumber: | 9135883877 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 07/01/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 04-29133 | KS | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 205331408 | 05 | MO | MEDICAID | 401550 | 01 | KS | FIRSTGUARD | OTHER | 29485043 | 01 | MO | BCBS KANSAS CITY | OTHER | 100397270A | 05 | KS | MEDICAID |