Provider Demographics
NPI:1831229749
Name:JAMES E REEVES DPM PA
Entity type:Organization
Organization Name:JAMES E REEVES DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:785-841-4225
Mailing Address - Street 1:930 IOWA ST
Mailing Address - Street 2:STE 2
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1835
Mailing Address - Country:US
Mailing Address - Phone:785-841-4225
Mailing Address - Fax:785-841-9866
Practice Address - Street 1:930 IOWA ST
Practice Address - Street 2:STE 2
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1835
Practice Address - Country:US
Practice Address - Phone:785-841-4225
Practice Address - Fax:785-841-9866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSP146213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS06701OtherMEDICARE ID - UNSPECIFIED
KS3026701701Medicaid
KS1173201OtherBC/BS NUMBER
KS0169270001Medicare NSC
KS06701OtherMEDICARE ID - UNSPECIFIED