=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427549591
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEVIN SCOTT REED MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/24/2018
-----------------------------------------------------
Last Update Date | 09/06/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7259 S BINGHAM JUNCTION BLVD
-----------------------------------------------------
City | MIDVALE
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84047-4860
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-930-3000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 153 MASON WAY
-----------------------------------------------------
City | MADISON
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39110-6817
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-595-9044
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | 31725
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------