Healthcare Provider Details

I. General information

NPI: 1528488327
Provider Name (Legal Business Name): JOSHUA DARREL REID DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2014
Last Update Date: 01/28/2022
Certification Date: 01/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 E MARKET PLACE DR
SPANISH FORK UT
84660-1396
US

IV. Provider business mailing address

819 E MARKET PLACE DR
SPANISH FORK UT
84660-1396
US

V. Phone/Fax

Practice location:
  • Phone: 385-344-6600
  • Fax: 385-344-6605
Mailing address:
  • Phone: 385-344-6600
  • Fax: 385-344-6605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9498498-1204
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: