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General NPI Number Information
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NPI Number | 1811715964
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Entity Type | Organization
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Legal Business Name | REED FAMILY MEDICINE LLC
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Dates
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Enumeration Date | 09/27/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 3930 MEZZANINE DR STE B
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City | LAFAYETTE
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State | IN
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Zip | 47905-8646
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Country | US
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Telephone | 765-588-6404
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Fax |
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Provider Business Mailing Address
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Address Line | 3930 MEZZANINE DR STE B
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City | LAFAYETTE
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State | IN
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Zip | 47905-8646
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Country | US
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Telephone | 765-588-6404
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. IAN E REED
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Credential | DO
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Telephone | 219-964-9818
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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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