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General NPI Number Information
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NPI Number | 1942585963
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Entity Type | Organization
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Legal Business Name | HERMAN L. REID III MD LLC
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Dates
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Enumeration Date | 10/21/2011
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Last Update Date | 03/02/2015
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Provider Practice Location Address
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Address Line | 7839 S PROFESSIONAL DR
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City | FORT BRANCH
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State | IN
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Zip | 47648-8405
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Country | US
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Telephone | 812-306-6631
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Fax | 812-867-6951
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Provider Business Mailing Address
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Address Line | 18920 ROSCOMMON RD
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City | EVANSVILLE
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State | IN
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Zip | 47725-6417
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Country | US
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Telephone | 812-306-6631
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Fax | 812-867-6951
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MARIA E PENN-REID
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Credential | BA
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Telephone | 812-306-6631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 01056394A
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License Number State | IN
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