Basic Information
| Provider Information | |||||||||
| NPI: | 1851486294 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BHARATI | ||||||||
| FirstName: | RALPH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8911 E ORME ST | ||||||||
| Address2: | SUITE A | ||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 67207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3166867884 | ||||||||
| FaxNumber: | 3166860036 | ||||||||
| Practice Location | |||||||||
| Address1: | 8911 E ORME ST | ||||||||
| Address2: | SUITE A | ||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 67207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3166867884 | ||||||||
| FaxNumber: | 3166860036 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 09/18/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 0421258 | KS | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0802X | 0421258 | KS | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 100151320 B | 05 | KS | MEDICAID |