Basic Information
| Provider Information | |||||||||
| NPI: | 1912969916 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HIERHOLZER | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1657 | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666011657 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852958108 | ||||||||
| FaxNumber: | 7852315991 | ||||||||
| Practice Location | |||||||||
| Address1: | 1700 SW 7TH ST | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666061674 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852955346 | ||||||||
| FaxNumber: | 7852315930 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2006 | ||||||||
| LastUpdateDate: | 10/27/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 420017 | KS | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 100409750C | 05 | KS | MEDICAID |