Healthcare Provider Details

I. General information

NPI: 1831534239
Provider Name (Legal Business Name): PAUL LANDON RIEKHOF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2013
Last Update Date: 04/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8922 LINDEN LN
PRAIRIE VILLAGE KS
66207-2283
US

IV. Provider business mailing address

4055 VALLEY VIEW LN SUITE 400
DALLAS TX
75244-5074
US

V. Phone/Fax

Practice location:
  • Phone: 913-209-4043
  • Fax:
Mailing address:
  • Phone: 913-209-4043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number04-14286
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: