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Individual

KENNETH DEAN REEVES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4740 EL MONTE ST, SHAWNEE MISSION, KS 66205-1348
(913) 362-1600
(913) 362-4452
Mailing address
4740 EL MONTE ST, SHAWNEE MISSION, KS 66205-1348
(913) 362-1600
(913) 362-4452

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
04-19247
KS
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
04-19247
KS
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
04-19247
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100198030A
KS
Enumeration date
09/28/2006
Last updated
06/03/2008
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