=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518059070
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BARBARA W REEVE M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/29/2006
-----------------------------------------------------
Last Update Date | 08/31/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 36 DEANE ST
-----------------------------------------------------
City | ELLSWORTH
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04605-2003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-667-0261
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 36 DEANE ST
-----------------------------------------------------
City | ELLSWORTH
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04605-2003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-667-0261
-----------------------------------------------------
Fax | 207-667-0849
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 013253
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------