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General NPI Number Information
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NPI Number | 1700895430
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Entity Type | Organization
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Legal Business Name | THOMAS K. REID, M.D., PROF. CORP.
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 01/28/2014
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Provider Practice Location Address
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Address Line | 157 PIONEER LN
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City | BISHOP
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State | CA
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Zip | 93514-2557
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Country | US
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Telephone | 760-873-8686
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Fax | 873-873-5507
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Provider Business Mailing Address
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Address Line | 157 PIONEER LN
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City | BISHOP
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State | CA
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Zip | 93514-2557
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Country | US
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Telephone | 760-873-8686
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Fax | 873-873-5507
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. MICHELLE LEIGH REID
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Credential |
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Telephone | 760-873-8686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A54353
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License Number State | CA
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