Healthcare Provider Details

I. General information

NPI: 1568466290
Provider Name (Legal Business Name): WILLIAM G REEVES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 GYPSY LN
YOUNGSTOWN OH
44504-1315
US

IV. Provider business mailing address

500 GYPSY LN
YOUNGSTOWN OH
44504-1315
US

V. Phone/Fax

Practice location:
  • Phone: 330-744-5558
  • Fax:
Mailing address:
  • Phone: 330-744-5558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number35-05-0178-R
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: