Healthcare Provider Details

I. General information

NPI: 1992968549
Provider Name (Legal Business Name): TONIA LYNN REID MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 08/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 NICHOLASVILLE RD BUILDING C, SUITE 406
LEXINGTON KY
40503-1471
US

IV. Provider business mailing address

1760 NICHOLASVILLE RD BUILDING C, SUITE 406
LEXINGTON KY
40503-1471
US

V. Phone/Fax

Practice location:
  • Phone: 859-276-4391
  • Fax: 859-278-0047
Mailing address:
  • Phone: 859-276-4391
  • Fax: 859-278-0047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number41040
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number41040
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number40140
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: