Healthcare Provider Details

I. General information

NPI: 1437104338
Provider Name (Legal Business Name): DONALD J. REED, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E GLORIA SWITCH RD
LAFAYETTE LA
70507-2512
US

IV. Provider business mailing address

600 E GLORIA SWITCH RD
LAFAYETTE LA
70507-2512
US

V. Phone/Fax

Practice location:
  • Phone: 337-235-6211
  • Fax: 337-235-0852
Mailing address:
  • Phone: 337-235-6211
  • Fax: 337-235-0852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number013834
License Number StateLA

VIII. Authorized Official

Name: SHEILA D VIDRINE
Title or Position: OFFICE MANAGER
Credential:
Phone: 337-235-6211