Healthcare Provider Details

I. General information

NPI: 1700029873
Provider Name (Legal Business Name): JOHN FRANKLIN REESE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2009
Last Update Date: 10/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 WINN WAY SUITE 220
DECATUR GA
30030-1707
US

IV. Provider business mailing address

445 WINN WAY SUITE 220
DECATUR GA
30030-1707
US

V. Phone/Fax

Practice location:
  • Phone: 404-508-7738
  • Fax:
Mailing address:
  • Phone: 404-508-7738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License NumberRPH023955
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: