Provider Demographics
NPI:1073573879
Name:MEYER, ORVEL WARREN (MD)
Entity Type:Individual
Prefix:
First Name:ORVEL
Middle Name:WARREN
Last Name:MEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:O
Other - Middle Name:WARREN
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:929 SW MULVANE ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1677
Mailing Address - Country:US
Mailing Address - Phone:785-270-4100
Mailing Address - Fax:785-270-4177
Practice Address - Street 1:929 SW MULVANE ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1677
Practice Address - Country:US
Practice Address - Phone:785-270-4100
Practice Address - Fax:785-270-4177
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-18904207RC0000X
NM77-221207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100197090CMedicaid
KS068002102OtherMEDICARE PTAN
KS068002102OtherMEDICARE PTAN
060020826OtherRAILROAD MEDICARE
KS068002102OtherMEDICARE PTAN
KSB68742Medicare UPIN