Provider Demographics
NPI:1154395770
Name:CURTIS, JEFFERY LANE (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:LANE
Last Name:CURTIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:600 PARK STREET
Mailing Address - Street 2:CSS-301
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601
Mailing Address - Country:US
Mailing Address - Phone:785-628-4401
Mailing Address - Fax:785-628-4089
Practice Address - Street 1:600 PARK STREET
Practice Address - Street 2:CSS-301
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601
Practice Address - Country:US
Practice Address - Phone:785-628-4401
Practice Address - Fax:785-628-4089
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-19671207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100177960CMedicaid
KS100177960CMedicaid
KS369434Medicare UPIN