Provider Demographics
NPI:1174587422
Name:DRIKS, MICHAEL R (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:R
Last Name:DRIKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4601 W 109TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1313
Mailing Address - Country:US
Mailing Address - Phone:913-942-0540
Mailing Address - Fax:630-528-9589
Practice Address - Street 1:4601 W 109TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1313
Practice Address - Country:US
Practice Address - Phone:913-942-0540
Practice Address - Fax:630-528-9589
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR9G03207RI0200X
KS04-25907207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100120500AMedicaid
MO202450300Medicaid
KS100120500AMedicaid
MO2786934AMedicare Oscar/Certification
MO2786934FMedicare Oscar/Certification