Provider Demographics
NPI:1437156890
Name:PRIDDLE, STEVEN ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ALLEN
Last Name:PRIDDLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1620 CHARLES PL
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2750
Mailing Address - Country:US
Mailing Address - Phone:785-776-1400
Mailing Address - Fax:785-776-7392
Practice Address - Street 1:1620 CHARLES PL
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2750
Practice Address - Country:US
Practice Address - Phone:785-776-1400
Practice Address - Fax:785-776-7392
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-26575207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP4640416OtherDEA NUMBER
G69496Medicare UPIN
BP4640416OtherDEA NUMBER