| Organization Name: | KU EYE SURGERY & LASER CENTER, LLC |
| NPI Number: | 1083952113 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN E SUTPHIN (PRESIDENT) |
| Mailing Address: | 7400 State Line Rd Suite 212 Prairie Village |
| State: | KS US |
| Postal Code: | 662083444 |
| Phone Number: | 9135882020 |
| Fax Number: | 9135741087 |
| NPI Enumeration Date: | 01/24/2013 |
| NPI Last Update Date: | 10/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS0132X |
| License Number: | 4652236 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ophthalmologic Surgery |
| Taxonomy Definition: | |