Healthcare Provider Details

I. General information

NPI: 1275734543
Provider Name (Legal Business Name): MELINDA RENEE REED M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 03/30/2020
Certification Date: 03/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 INDEPENDENCE SQ
WEST PLAINS MO
65775-4238
US

IV. Provider business mailing address

5912 S STOCKTON AVE
SPRINGFIELD MO
65804-7559
US

V. Phone/Fax

Practice location:
  • Phone: 417-256-1764
  • Fax: 417-256-1736
Mailing address:
  • Phone: 417-882-0215
  • Fax: 417-882-0215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number2008035481
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: