Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 1200140 | KS |
NPI | 1255341236 |
---|---|
Provider Name | Warren W Abbott |
First Address | Topeka, KS 66667-0143 |
Second Address | Topeka, KS 66604-4510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 05/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
480922518 | FEIN (01) | KS |
826480159 | RAILROAD MEDICARE ID# (01) | KS |
T43829 | (02) | KS |