Healthcare Provider Details

I. General information

NPI: 1033176235
Provider Name (Legal Business Name): DAVID G. REED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 05/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 W 7TH ST
WRAY CO
80758-1420
US

IV. Provider business mailing address

1017 W 7TH ST
WRAY CO
80758-1420
US

V. Phone/Fax

Practice location:
  • Phone: 970-332-4895
  • Fax: 970-332-3235
Mailing address:
  • Phone: 970-332-4895
  • Fax: 970-332-3235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number430740
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21961
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5782A
License Number StateWY
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number33999
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: