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General NPI Number Information
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NPI Number | 1053385443
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Entity Type | Individual
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Provider Name | DAVID M REILLY M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 12/01/2023
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Provider Practice Location Address
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Address Line | 350 HOSPITAL WAY SUITE 100
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City | SOMERSET
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State | KY
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Zip | 42503-2872
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Country | US
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Telephone | 606-451-2601
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Fax | 606-451-2641
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Provider Business Mailing Address
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Address Line | 3655 KENT DR
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City | NAPLES
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State | FL
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Zip | 34112-3753
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Country | US
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Telephone | 606-875-1369
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 31406
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME134181
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License Number State | FL
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