Ilyasov, Andrey Alexandrovich
Ilyasov, Andrey Alexandrovich is an individual health care provider with primary practice located at 315 W 15Th St , Liberal KS 67901-2455. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Ilyasov, Andrey Alexandrovich can be contacted via phone (620) 629-6477.Contact Information
Primary practice address
315 W 15Th St
Liberal KS 67901-2455
Phone: (620) 629-6477
Fax: (620) 629-6651
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 34051 | South Carolina |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 200501714 | North Carolina |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 04-37011 | Kansas |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 35106 | Alabama |
Profile Details
| NPI number | 1972575587 |
|---|---|
| LBN Legal business name | Ilyasov, Andrey Alexandrovich |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 7th, 2006 |
| Last updated | Mar 8th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972575587 | NPPES |
| North Carolina | Other | P00435714 | RAILROAD MEDICARE |
| North Carolina | MEDICAID | 5902572 | RAILROAD MEDICARE |
| North Carolina | MEDICAID | 200554510A | RAILROAD MEDICARE |
| North Carolina | MEDICAID | 201122270A | RAILROAD MEDICARE |
Popular Providers
-
Dantzler, Leon E
101 Robeson St Suite 300, Fayetteville NC 28301-5552 -
Klugewicz, Christopher J
1 Medical Center Blvd , Cookeville TN 38501-4294 -
Abrams, Jeffrey R
493 Blackwell Rd Ste 101A , Warrenton VA 20186-2628 -
Manak, Charles J
5777 E Mayo Blvd , Phoenix AZ 85054 -
Vergara, Cleofemarie S
6900 N Pecos Rd , North Las Vegas NV 89086-4400 -
Cross, Tracy Glenn
250 Burkesville Rd , Albany KY 42602-1604 -
Enyenihi, Henry Nubung
11121 Highway 70 Suite 101, Arlington TN 38002-9230 -
Hamami, Anwar
5700 Darrow Rd Suite 106, Hudson OH 44236