Provider Demographics
NPI:1972552933
Name:REESE, ADAM R (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:R
Last Name:REESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-3366
Mailing Address - Country:US
Mailing Address - Phone:913-588-6670
Mailing Address - Fax:
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-3366
Practice Address - Country:US
Practice Address - Phone:913-588-6670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003028781207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO33416012OtherBCBS NUMBER
MO200004520AMedicaid
MO209020304Medicaid
MOP00114702OtherRR MEDICARE NUMBER
MOH81535Medicare UPIN
MO200004520AMedicaid