Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 6919 | KS |
Y | 213EG0000X | General Practice | 6919 | KS |
NPI | 1003894791 |
---|---|
Provider Name | Dr. Michael P Rack |
First Address | Topeka, KS 66603-3061 |
Second Address | Topeka, KS 66603-3061 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2006 |
Last Update Date | 08/07/2007 |