Provider Demographics
NPI:1962403642
Name:REUBEN, JOSEPH B (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:B
Last Name:REUBEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 411039
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-1039
Mailing Address - Country:US
Mailing Address - Phone:913-234-1350
Mailing Address - Fax:
Practice Address - Street 1:12300 METCALF AVE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1324
Practice Address - Country:US
Practice Address - Phone:913-317-7485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-28573207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
01674018OtherBCBS KC MO GROUP 01674018
930114375OtherRR MEDICARE GROUP CG8899
P00211286OtherRR MEDICARE GROUP DC6712
MO26502051OtherBCBS OD KC MO
MO206039000Medicaid
MO100358100CMedicaid
26502031OtherBCBS KCMO
KS100358100AMedicaid
P00211286OtherRR MEDICARE GROUP DC6712
MO26502051OtherBCBS OD KC MO
KSH07370Medicare UPIN