1487657409 NPI number — DR. ROBERT L PIERRON M.D.

Table of content: DR. ROBERT L PIERRON M.D. (NPI 1487657409)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487657409 NPI number — DR. ROBERT L PIERRON M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PIERRON
Provider First Name:
ROBERT
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487657409
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 741331
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30374-1331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-469-6447
Provider Business Mailing Address Fax Number:
913-338-1311

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10600 MASTIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OVERLAND PARK
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66212-5723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-469-6447
Provider Business Practice Location Address Fax Number:
913-825-3716
Provider Enumeration Date:
05/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  R2A47 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207X00000X , with the licence number: 04-16839 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 43441V3458 . This is a "GHP/ADVANTRA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9000589 . This is a "UHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 351240001 . This is a "CIGNA DMERC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 21192 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 82924 . This is a "CMR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 102054 . This is a "HEALTHLINK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4422V6097 . This is a "HEALTHCARE USA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2605735 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3053848 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".




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