ANDREY ALEXANDROVICH ILYASOV

LIBERAL, KS
NPI1972575587
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208M00000X Hospitalist
(Licence: KS  04-37011)
Additional Taxonomies207R00000X Internal Medicine
(Licence: SC  34051)
207R00000X Internal Medicine
(Licence: NC  200501714)
208M00000X Hospitalist
(Licence: AL  35106)
Enumeration Date2006-02-07
Last Update Date2017-03-08
Business Address
Dr. ANDREY ALEXANDROVICH ILYASOV MD
315 W 15TH ST
LIBERAL, KS 67901-2455
Phone number: 620-629-6477
Mailing Address
Dr. ANDREY ALEXANDROVICH ILYASOV MD
PO BOX 1215 ATTN CLINIC BILLING OFFICE
LIBERAL, KS 67905-1215
Phone number: 620-629-6638