Healthcare Provider Details

I. General information

NPI: 1255446175
Provider Name (Legal Business Name): WILLIAM STUART REID JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 01/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 W CLINCH AVE SUITE 214
KNOXVILLE TN
37916-2434
US

IV. Provider business mailing address

1819 W CLINCH AVE SUITE 214
KNOXVILLE TN
37916-2434
US

V. Phone/Fax

Practice location:
  • Phone: 865-541-2835
  • Fax: 865-541-1003
Mailing address:
  • Phone: 865-541-2835
  • Fax: 865-541-1003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number0000011917
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: