Provider Demographics
NPI:1417906074
Name:RICHARD A REEVES AND LARRY D STOPPEL OD PA
Entity Type:Organization
Organization Name:RICHARD A REEVES AND LARRY D STOPPEL OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:STOPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:785-325-2289
Mailing Address - Street 1:318 C ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:66968-1909
Mailing Address - Country:US
Mailing Address - Phone:785-325-2289
Mailing Address - Fax:785-325-3435
Practice Address - Street 1:318 C ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:KS
Practice Address - Zip Code:66968-1909
Practice Address - Country:US
Practice Address - Phone:785-325-2289
Practice Address - Fax:785-325-3435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1110-3152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100090190AMedicaid
KS100217960AMedicaid
KS200576690AMedicaid
KS4008180003Medicare NSC
KS1295701183Medicare PIN
KS200576690AMedicaid
KS100217960AMedicaid
KS100090190AMedicaid
KS065160Medicare PIN
KS1417906074Medicare PIN