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NPI Code Detail

MEDICARE: DR. DONALD PEARSON REESE M.D.

MEDICARE: DR. DONALD PEARSON REESE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine Physician036135513IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OTH000OTHERILUPIN

General Provider Information

NPI Number : 1053632406
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONALD PEARSON REESE M.D.
Provider Business Mailing Address
First Line : 1120 N MELVIN ST
Second Line :
City : GIBSON CITY
State : IL
Zip : 60936-1477
Country : US
Telephone Number : 217-379-4864
Fax Number : 773-378-4028
Provider Business Practice Location Address
First Line : 227 N MARKET ST
Second Line :
City : PAXTON
State : IL
Zip : 60957-1123
Country : US
Telephone Number : 217-379-4864
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2010
Last Update Date : 08/11/2020

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