Provider Demographics
NPI:1659312221
Name:PRIBIL, ALAN N (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:N
Last Name:PRIBIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:420 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:PRATT
Mailing Address - State:KS
Mailing Address - Zip Code:67124-3125
Mailing Address - Country:US
Mailing Address - Phone:620-672-7415
Mailing Address - Fax:620-672-7414
Practice Address - Street 1:420 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:PRATT
Practice Address - State:KS
Practice Address - Zip Code:67124-3125
Practice Address - Country:US
Practice Address - Phone:620-672-7415
Practice Address - Fax:620-672-7414
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12735207R00000X
KS0424955207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS02134OtherPREFERRED HEALTH SYSTEMS
KS100155120AMedicaid
KS22716OtherCOVENTRY HEALTH CARE
KSA005OtherTRICARE
KS100619OtherHEALTH PARTNERS OF KANSAS
KS000811OtherRURAL HEALTH BLUE CROSS
KS046098OtherKANSAS BCBS
KS100088840BMedicaid
KS612640OtherFIRSTGUARD
KS046098Medicare ID - Type UnspecifiedKANSAS PART B