Provider Demographics
NPI:1235684754
Name:ANDRES, JOHN LEE (DVM)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LEE
Last Name:ANDRES
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:KS
Mailing Address - Zip Code:66434-2730
Mailing Address - Country:US
Mailing Address - Phone:785-742-2147
Mailing Address - Fax:785-742-3133
Practice Address - Street 1:1205 S 1ST ST
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:KS
Practice Address - Zip Code:66434-2730
Practice Address - Country:US
Practice Address - Phone:785-742-2147
Practice Address - Fax:785-742-3133
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4215174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist