Organization
JOHN RILEY IV, D.P.M., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN J RILEY IV DPM (DOCTOR)
(816) 561-7388
Entity
Organization
Contact information
Practice address
411 NICHOLS RD, SUITE 174, KANSAS CITY, MO 64112-2000
(816) 561-7388
(816) 561-9921
Mailing address
411 NICHOLS RD, SUITE 174, KANSAS CITY, MO 64112-2000
(816) 561-7388
(816) 561-9921
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548234586
—
MO
01
—
29539016
BCBSKC & PHP
MO
01
—
615154500
DOL
MO
01
—
CJ2991
RR MEDICARE
MO
01
—
DQ2915
RR MEDICARE
KS
Enumeration date
02/15/2006
Last updated
03/27/2012
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