1831229749 NPI number — JAMES E REEVES DPM PA

Table of content: (NPI 1831229749)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831229749 NPI number — JAMES E REEVES DPM PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES E REEVES DPM PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1831229749
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/19/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
930 IOWA ST
Provider Second Line Business Mailing Address:
STE 2
Provider Business Mailing Address City Name:
LAWRENCE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66044-1835
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-841-4225
Provider Business Mailing Address Fax Number:
785-841-9866

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
930 IOWA ST
Provider Second Line Business Practice Location Address:
STE 2
Provider Business Practice Location Address City Name:
LAWRENCE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66044-1835
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-841-4225
Provider Business Practice Location Address Fax Number:
785-841-9866
Provider Enumeration Date:
03/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
REEVES
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
785-841-4225

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  P146 , 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: 06701 . This is a "MEDICARE ID - UNSPECIFIED" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 3026701701 , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1173201 . This is a "BC/BS NUMBER" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com