Organization
SUHAIL ANSARI, MD, CHARTERED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUHAIL ANSARI MD (PRESIDENT)
(620) 624-6222
Entity
Organization
Contact information
Practice address
2138 N KANSAS AVE, LIBERAL, KS 67901-2012
(620) 624-6222
(620) 624-5413
Mailing address
2138 N KANSAS AVE, LIBERAL, KS 67901-2012
(620) 624-6222
(620) 624-5413
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100380740A
—
KS
01
—
115607
BLUE CROSS BLUE SHIELD
KS
Enumeration date
02/08/2006
Last updated
12/13/2019
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