MEDICARE: DR. KIRK T REED O D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	00897	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497735294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIRK T REED O D

Provider Business Mailing Address
First Line	:	20715 E OCOTILLO RD STE 101
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-6118
Country	:	US
Telephone Number	:	480-987-3400
Fax Number	:	480-987-3406

Provider Business Practice Location Address
First Line	:	20715 E OCOTILLO RD STE 101
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-6118
Country	:	US
Telephone Number	:	480-987-3400
Fax Number	:	480-987-3406

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	07/17/2023

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