Healthcare Provider Details

I. General information

NPI: 1922108497
Provider Name (Legal Business Name): GUY L. REED III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 10/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 UNION AVE SUITE 200
MEMPHIS TN
38104-3627
US

IV. Provider business mailing address

1407 UNION AVE SUITE 640
MEMPHIS TN
38104-3627
US

V. Phone/Fax

Practice location:
  • Phone: 901-866-8813
  • Fax: 901-302-2120
Mailing address:
  • Phone: 901-866-8373
  • Fax: 901-302-2360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number43969
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number054923
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: