Provider Demographics
NPI:1487613790
Name:KANSAS SURGICAL ASSOCIATES LLC
Entity type:Organization
Organization Name:KANSAS SURGICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:HUEBNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:620-231-6160
Mailing Address - Street 1:1011 S MOUNT CARMEL PL
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-6604
Mailing Address - Country:US
Mailing Address - Phone:620-231-6160
Mailing Address - Fax:620-235-0175
Practice Address - Street 1:1011 S MOUNT CARMEL PL
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-6604
Practice Address - Country:US
Practice Address - Phone:620-231-6160
Practice Address - Fax:620-235-0175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
111140Medicare ID - Type Unspecified