Provider Demographics
NPI:1821054693
Name:VOBORIL, REGGIE J (MD)
Entity Type:Individual
Prefix:
First Name:REGGIE
Middle Name:J
Last Name:VOBORIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1188
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66505-1188
Mailing Address - Country:US
Mailing Address - Phone:785-537-2651
Mailing Address - Fax:785-537-2975
Practice Address - Street 1:1133 COLLEGE AVE
Practice Address - Street 2:SUITE E-110
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2770
Practice Address - Country:US
Practice Address - Phone:785-537-2651
Practice Address - Fax:785-537-2975
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-29050207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS102019Medicare PIN
KSH42139Medicare UPIN