MEDICARE: JEREMY L REED PA-C

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1902420540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMY L REED PA-C

Provider Business Mailing Address
First Line	:	6406 W BUCKSKIN TRL
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85083-3445
Country	:	US
Telephone Number	:	623-341-5728
Fax Number	:

Provider Business Practice Location Address
First Line	:	6406 W BUCKSKIN TRL
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85083-3445
Country	:	US
Telephone Number	:	623-341-5728
Fax Number	:

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

Provider Enumeration Date	:	05/29/2020
Last Update Date	:	05/29/2020

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Directions to “ JEREMY L REED PA-C” Practice Location

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