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General NPI Number Information
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NPI Number | 1033250857
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Entity Type | Organization
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Legal Business Name | REESE FAMILY HEALTHCARE, LLC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 12/05/2007
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Provider Practice Location Address
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Address Line | 100 TREMON ST
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City | GORDON
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State | GA
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Zip | 31031-5013
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Country | US
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Telephone | 478-628-1515
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Fax |
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Provider Business Mailing Address
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Address Line | 3025 BRECKINRIDGE BLVD SUITE 120
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City | DULUTH
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State | GA
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Zip | 30096-7611
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Country | US
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Telephone | 678-226-0082
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MORRIS E REESE
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Credential | MD
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Telephone | 478-628-1515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 040769
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License Number State | GA
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