Organization
KU EYE SURGERY & LASER CENTER, LLC
Active
Parent organization
KANSAS UNIVERSITY OPHTHALMIC FOUNDATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
KANSAS UNIVERSITY OPHTHALMIC FOUNDATION
Authorized official
DR. JOHN E SUTPHIN MD (PRESIDENT)
(913) 588-6606
Entity
Organization
Contact information
Practice address
7400 STATE LINE RD, SUITE 212, PRAIRIE VILLAGE, KS 66208-3444
(913) 588-2020
(913) 574-1087
Mailing address
7400 STATE LINE RD, SUITE 100, PRAIRIE VILLAGE, KS 66208-3444
(913) 588-6626
(913) 588-0888
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
4652236
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201099022A
—
KS
01
—
KA3250
MEDICARE PTAN
—
Enumeration date
01/24/2013
Last updated
10/19/2015
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