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General NPI Number Information
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NPI Number | 1538299342
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Entity Type | Organization
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Legal Business Name | REID PHYSICIAN ASSOCIATES, INC.
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 09/22/2015
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Provider Practice Location Address
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Address Line | 105 E 2ND ST
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City | RIDGEVILLE
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State | IN
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Zip | 47380-1325
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Country | US
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Telephone | 765-857-2523
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Fax | 765-857-2304
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Provider Business Mailing Address
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Address Line | 1100 REID PKWY MEDICAL STAFF SERVICES
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City | RICHMOND
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State | IN
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Zip | 47374-1157
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Country | US
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Telephone | 765-935-8806
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Fax | 765-983-3219
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | CRAIG KINYON
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Credential |
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Telephone | 765-983-3127
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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 |
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License Number State |
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