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General NPI Number Information
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NPI Number | 1265452379
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Entity Type | Individual
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Provider Name | JOHN EARL REAVES JR. MD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 09/12/2019
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Provider Practice Location Address
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Address Line | 1870 CHACE DR STE 160
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City | HOOVER
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State | AL
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Zip | 35244-7104
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Country | US
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Telephone | 205-733-7110
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Fax | 205-733-7859
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Provider Business Mailing Address
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Address Line | 1870 CHACE DR STE 160
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City | HOOVER
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State | AL
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Zip | 35244-7104
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Country | US
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Telephone | 205-733-7110
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Fax | 205-733-7859
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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 | 01069653A
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License Number State | IN
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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 | 38828
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD.15271
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License Number State | AL
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