Provider Demographics
NPI:1972519247
Name:REIFSCHNEIDER, JOHN STEVEN (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:STEVEN
Last Name:REIFSCHNEIDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1001 6TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-3222
Mailing Address - Country:US
Mailing Address - Phone:913-682-2900
Mailing Address - Fax:913-682-8913
Practice Address - Street 1:1001 6TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-3222
Practice Address - Country:US
Practice Address - Phone:913-682-2900
Practice Address - Fax:913-682-8913
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0523244207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS046142OtherBCBSKS
MO16241048OtherBCBSKC
MO632700OtherFIRST GUARD
KS180045348OtherMEDICARE RAIL ROAD
KS100234140AMedicaid
MO632700OtherFIRST GUARD