Healthcare Provider Details

I. General information

NPI: 1538472899
Provider Name (Legal Business Name): CHAD R REID M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2010
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5602 SW LEE BLVD
LAWTON OK
73505-9635
US

IV. Provider business mailing address

5602 SW LEE BLVD ATTN: PRACTICE MANAGEMENT
LAWTON OK
73505-9635
US

V. Phone/Fax

Practice location:
  • Phone: 580-531-4890
  • Fax: 580-531-4981
Mailing address:
  • Phone: 580-531-4890
  • Fax: 580-531-4981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number341649
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number30134
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number30134
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2010020758
License Number StateMO
# 5
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01083618A
License Number StateIN
# 6
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME176937
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number01083618A
License Number StateIN
# 8
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME176937
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: