Healthcare Provider Details

I. General information

NPI: 1518281393
Provider Name (Legal Business Name): JOSHUA ALBERT REED
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2010
Last Update Date: 03/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 N 31ST ST
CLINTON OK
73601-9116
US

IV. Provider business mailing address

2205 LYNN LN
WEATHERFORD OK
73096-2969
US

V. Phone/Fax

Practice location:
  • Phone: 580-323-6021
  • Fax: 580-323-9375
Mailing address:
  • Phone: 580-302-0783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: