Provider Demographics
NPI:1306872023
Name:UNIVERSITY OF KANSAS MEDICAL CENTER
Entity type:Organization
Organization Name:UNIVERSITY OF KANSAS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:DARRYL
Authorized Official - Last Name:QUARLES
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:913-588-9252
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:6018 WAHL HALL EAST, MS 3018
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:913-588-9252
Mailing Address - Fax:913-588-9251
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:6018 WAHL HALL EAST, MS 3018
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-9252
Practice Address - Fax:913-588-9251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-30604281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AQ9801336Medicare UPIN