Healthcare Provider Details

I. General information

NPI: 1053381194
Provider Name (Legal Business Name): THOMAS MICHAEL REID M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S 1000 W
TOOELE UT
84074-4010
US

IV. Provider business mailing address

8960 CHESHIRE DR
SANDY UT
84093-1851
US

V. Phone/Fax

Practice location:
  • Phone: 435-843-3520
  • Fax: 435-843-3555
Mailing address:
  • Phone: 801-733-5988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number932631271205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: