Provider Demographics
NPI:1114971611
Name:NEMECHEK, VICTOR M (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:M
Last Name:NEMECHEK
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 1:826 18TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:HOXIE
Mailing Address - State:KS
Mailing Address - Zip Code:67740-4373
Mailing Address - Country:US
Mailing Address - Phone:785-675-3018
Mailing Address - Fax:785-675-2306
Practice Address - Street 1:826 18TH ST STE A
Practice Address - Street 2:
Practice Address - City:HOXIE
Practice Address - State:KS
Practice Address - Zip Code:67740-4373
Practice Address - Country:US
Practice Address - Phone:785-675-3018
Practice Address - Fax:785-675-2306
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS21357207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100203910BMedicaid
KS100203910BMedicaid
KSB91222Medicare UPIN
KS100203910AMedicaid