Provider Demographics
NPI:1134167844
Name:ADVANCED SPINE & ORTHOPAEDIC SPECIALISTS, PA
Entity type:Organization
Organization Name:ADVANCED SPINE & ORTHOPAEDIC SPECIALISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:O
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-649-7300
Mailing Address - Street 1:PO BOX 411703
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-1703
Mailing Address - Country:US
Mailing Address - Phone:913-649-7300
Mailing Address - Fax:913-385-5559
Practice Address - Street 1:10730 NALL AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1206
Practice Address - Country:US
Practice Address - Phone:913-649-7300
Practice Address - Fax:913-385-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO34297011OtherBC/BS OF KC GROUP #
KS118343002OtherDME GROUP NUMBER
MO34297011OtherBC/BS OF KC GROUP #
KS118343002OtherDME GROUP NUMBER
1183430002Medicare NSC
MOF700000CMedicare PIN