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NPI Code Detail

MEDICARE: RENEE E REEDER OD

MEDICARE: RENEE E REEDER OD
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
1152W00000XOptometrist046009035IL
2152W00000XOptometrist2135DTKY

Other Identifiers

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

General Provider Information

NPI Number : 1871586289
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENEE E REEDER OD
Provider Business Mailing Address
First Line : 147 SYCAMORE ST
Second Line :
City : PIKEVILLE
State : KY
Zip : 41501-9118
Country : US
Telephone Number : 606-218-5540
Fax Number : 606-218-5541
Provider Business Practice Location Address
First Line : 147 SYCAMORE ST
Second Line :
City : PIKEVILLE
State : KY
Zip : 41501-9118
Country : US
Telephone Number : 606-218-5540
Fax Number : 606-218-5541
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2005
Last Update Date : 07/10/2020

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