Basic Information
Provider Information
NPI: 1902202625
EntityType: 2
ReplacementNPI:  
OrganizationName: OCCUPATIONAL HEALTH CENTERS OF KANSAS PA
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: CONCENTRA MEDICAL CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5080 SPECTRUM DR
Address2: SUITE 1200 WEST
City: ADDISON
State: TX
PostalCode: 750014648
CountryCode: US
TelephoneNumber: 9727207772
FaxNumber: 2147754502
Practice Location
Address1: 14809 W 95TH ST
Address2:  
City: LENEXA
State: KS
PostalCode: 662155220
CountryCode: US
TelephoneNumber: 9138946664
FaxNumber: 2147754502
Other Information
ProviderEnumerationDate: 11/06/2014
LastUpdateDate: 06/30/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ZIPORIN
AuthorizedOfficialFirstName: ARTHUR
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT / TREASURER
AuthorizedOfficialTelephone: 9723648000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QH0100X  Y Ambulatory Health Care FacilitiesClinic/CenterHealth Service

No ID Information.


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