Healthcare Provider Details
I. General information
NPI: 1134167844
Provider Name (Legal Business Name): ADVANCED SPINE & ORTHOPAEDIC SPECIALISTS, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/03/2006
Last Update Date: 03/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10730 NALL AVE SUITE 200
OVERLAND PARK KS
66211-1206
US
IV. Provider business mailing address
PO BOX 411703
KANSAS CITY MO
64141-1703
US
V. Phone/Fax
- Phone: 913-649-7300
- Fax: 913-385-5559
- Phone: 913-649-7300
- Fax: 913-385-5559
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
WILLIAM
O
REED
Title or Position: OWNER
Credential: M.D.
Phone: 913-649-7300