Provider Demographics
NPI:1124136106
Name:KANSAL EYE PHYSICIANS AND SURGEONS CHTD
Entity type:Organization
Organization Name:KANSAL EYE PHYSICIANS AND SURGEONS CHTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SUKESH
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:KANSAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-825-2003
Mailing Address - Street 1:1499 E IRON AVE
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3233
Mailing Address - Country:US
Mailing Address - Phone:785-825-2003
Mailing Address - Fax:785-825-2015
Practice Address - Street 1:1499 E IRON AVE
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3233
Practice Address - Country:US
Practice Address - Phone:785-825-2003
Practice Address - Fax:785-825-2015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0430169174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS111070Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER