MEDICARE: DR. RICHARD GIL REESE DPH

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	183500000X	Pharmacist	4173	TN

General Provider Information

NPI Number	:	1750421053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD GIL REESE DPH

Provider Business Mailing Address
First Line	:	1020 THORNTREE DR
Second Line	:
City	:	DYERSBURG
State	:	TN
Zip	:	38024-2831
Country	:	US
Telephone Number	:	731-286-8050
Fax Number	:

Provider Business Practice Location Address
First Line	:	705 E REELFOOT AVE
Second Line	:
City	:	UNION CITY
State	:	TN
Zip	:	38261-5883
Country	:	US
Telephone Number	:	731-885-9441
Fax Number	:	731-885-7861

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

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	07/08/2007

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