Healthcare Provider Details

I. General information

NPI: 1366401929
Provider Name (Legal Business Name): GEORGE R REISZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 HOLMES ST
KANSAS CITY MO
64108-2640
US

IV. Provider business mailing address

2310 HOLMES ST
KANSAS CITY MO
64108-2634
US

V. Phone/Fax

Practice location:
  • Phone: 816-404-1000
  • Fax:
Mailing address:
  • Phone: 816-218-2500
  • Fax: 816-421-7379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberR8814
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: