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General NPI Number Information
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NPI Number | 1194904326
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Entity Type | Organization
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Legal Business Name | REED M. BOUCHEY, M.D., P.C.
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 01/03/2008
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Provider Practice Location Address
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Address Line | 501 S WHITE ST SUITE 105
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City | MOUNT PLEASANT
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State | IA
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Zip | 52641-2600
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Country | US
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Telephone | 319-385-6775
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Fax | 319-385-6778
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Provider Business Mailing Address
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Address Line | 501 S WHITE ST SUITE 105
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City | MOUNT PLEASANT
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State | IA
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Zip | 52641-2600
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Country | US
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Telephone | 319-385-6775
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Fax | 319-385-6778
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. REED MUNRO BOUCHEY
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Credential | M.D., P.C.
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Telephone | 319-385-6775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 26041
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License Number State | IA
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