Healthcare Provider Details

I. General information

NPI: 1780639443
Provider Name (Legal Business Name): HUGH MALLORY REEVES JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MONUMENT RD STE 190
YORK PA
17403-5059
US

IV. Provider business mailing address

25 MONUMENT RD STE 190
YORK PA
17403-5059
US

V. Phone/Fax

Practice location:
  • Phone: 717-741-8011
  • Fax: 717-255-0966
Mailing address:
  • Phone: 717-741-8011
  • Fax: 717-255-0966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number2006-00418
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD496488
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: