Provider Demographics
NPI:1730151671
Name:ULUSARAC, ASIM (MD)
Entity type:Individual
Prefix:DR
First Name:ASIM
Middle Name:
Last Name:ULUSARAC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12715 W 138TH TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-4140
Mailing Address - Country:US
Mailing Address - Phone:913-685-0995
Mailing Address - Fax:
Practice Address - Street 1:305 NW ENGLEWOOD CT
Practice Address - Street 2:SUITE 300
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4072
Practice Address - Country:US
Practice Address - Phone:816-453-7473
Practice Address - Fax:816-453-1940
Is Sole Proprietor?:No
Enumeration Date:2006-02-05
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0361872084P0800X
KS309812084P0800X
AL212442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H10559Medicare UPIN
MOI32D544Medicare ID - Type Unspecified