Provider Demographics
NPI:1396097218
Name:CHANUTE RT ASSOCIATES
Entity type:Organization
Organization Name:CHANUTE RT ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KLISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-749-3600
Mailing Address - Street 1:330 ARKANSAS
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1335
Mailing Address - Country:US
Mailing Address - Phone:785-749-3600
Mailing Address - Fax:785-749-3621
Practice Address - Street 1:1709 W 7TH STREET
Practice Address - Street 2:
Practice Address - City:CHANUTE
Practice Address - State:KS
Practice Address - Zip Code:66720-2505
Practice Address - Country:US
Practice Address - Phone:620-431-4815
Practice Address - Fax:620-431-4816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201077880BMedicaid
KS201077880BMedicaid