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General NPI Number Information
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NPI Number | 1598948085
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Entity Type | Organization
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Legal Business Name | JEANNE E REISS MD PA
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 373 W 101ST TERR
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City | KANSAS CITY
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State | MO
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Zip | 64114-4408
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Country | US
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Telephone | 913-438-2226
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Fax | 913-438-2227
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Provider Business Mailing Address
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Address Line | PO BOX 14250
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City | SHAWNEE MISSION
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State | KS
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Zip | 66285-4250
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Country | US
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Telephone | 913-438-2226
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Fax | 913-438-2227
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEANNE E REISS
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Credential | M.D.
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Telephone | 913-438-2226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | R3610
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License Number State | MO
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