Provider Demographics
NPI:1053395673
Name:EUBANKS, KIMBER L (MD)
Entity type:Individual
Prefix:
First Name:KIMBER
Middle Name:L
Last Name:EUBANKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26141
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64196-6141
Mailing Address - Country:US
Mailing Address - Phone:913-901-8880
Mailing Address - Fax:913-901-8898
Practice Address - Street 1:10501 METCALF AVE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1815
Practice Address - Country:US
Practice Address - Phone:913-901-8880
Practice Address - Fax:913-901-8898
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0422629207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS720000134OtherRR MEDICARE
KSM050610Medicare PIN