Basic Information
| Provider Information | |||||||||
| NPI: | 1548411853 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CANCER CENTER OF KANSAS, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 27005 | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662255277 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3166134263 | ||||||||
| FaxNumber: | 3162620706 | ||||||||
| Practice Location | |||||||||
| Address1: | 315 W. 15TH ST. | ||||||||
| Address2: | |||||||||
| City: | LIBERAL | ||||||||
| State: | KS | ||||||||
| PostalCode: | 679012455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6206296727 | ||||||||
| FaxNumber: | 6206296729 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2008 | ||||||||
| LastUpdateDate: | 06/10/2017 | ||||||||
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| AuthorizedOfficialLastName: | ABRAHAM | ||||||||
| AuthorizedOfficialFirstName: | YOOSAF | ||||||||
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| AuthorizedOfficialTitleorPosition: | C.O.O. | ||||||||
| AuthorizedOfficialTelephone: | 3166134256 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.