MEDICARE: JAY REID MD

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
1	207P00000X	Emergency Medicine Physician	6874	NV

General Provider Information

NPI Number	:	1073552717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY REID MD

Provider Business Mailing Address
First Line	:	9270 PRAIRIE ASTER PL
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4822
Country	:	US
Telephone Number	:	702-838-7502
Fax Number	:

Provider Business Practice Location Address
First Line	:	9270 PRAIRIE ASTER PL
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4822
Country	:	US
Telephone Number	:	702-838-7502
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	04/04/2008

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Directions to “ JAY REID MD” Practice Location

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