Provider Demographics
NPI:1194743062
Name:TATE, CHAD R (MD)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:R
Last Name:TATE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:330 ARKANSAS ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1335
Mailing Address - Country:US
Mailing Address - Phone:785-505-2200
Mailing Address - Fax:785-505-5237
Practice Address - Street 1:330 ARKANSAS ST
Practice Address - Street 2:SUITE 202
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1335
Practice Address - Country:US
Practice Address - Phone:785-505-2200
Practice Address - Fax:785-505-5237
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2020-12-09
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Provider Licenses
StateLicense IDTaxonomies
KS0435515208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200851190AMedicaid
KSKA1613010Medicare PIN