Basic Information
| Provider Information | |||||||||
| NPI: | 1710116215 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOURELIS | ||||||||
| FirstName: | KONSTANTINOS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | DEPT OF OTOLARYNGOLOGY HEAD AND NECK SURGERY | ||||||||
| Address2: | 3901 RAINBOW BOULEVARD | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661600001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135886719 | ||||||||
| FaxNumber: | 9135884676 | ||||||||
| Practice Location | |||||||||
| Address1: | DEPT OF OTOLARYNGOLOGY HEAD AND NECK SURGERY | ||||||||
| Address2: | 3901 RAINBOW BOULEVARD | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661600001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135886719 | ||||||||
| FaxNumber: | 9135884676 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2009 | ||||||||
| LastUpdateDate: | 07/07/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 7162 | KS | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.