Provider Demographics
NPI:1629044433
Name:BIEKER, JODY J (MD)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:J
Last Name:BIEKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MCPHERSON
Mailing Address - State:KS
Mailing Address - Zip Code:67460-2326
Mailing Address - Country:US
Mailing Address - Phone:620-241-2250
Mailing Address - Fax:620-798-2630
Practice Address - Street 1:1000 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460-2326
Practice Address - Country:US
Practice Address - Phone:620-241-2250
Practice Address - Fax:620-798-2630
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS31683207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS103825OtherBLUE CROSS/BLUE SHIELD
KS103825OtherBLUE CROSS/BLUE SHIELD
KSI13315Medicare UPIN