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NPI Code Detail

MEDICARE: REID PHYSICIAN ASSOCIATES, INC.

MEDICARE: REID PHYSICIAN ASSOCIATES, INC.
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
1207Y00000XOtolaryngology PhysicianIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134193410
Entity Type Code : Organization
Provider Name (Legal Business Name) : REID PHYSICIAN ASSOCIATES, INC.
Provider Business Mailing Address
First Line : 1100 REID PARKWAY, MEDICAL STAFF SERVICES
Second Line :
City : RICHMOND
State : IN
Zip : 47374-5547
Country : US
Telephone Number : 765-966-1600
Fax Number : 765-962-9641
Provider Business Practice Location Address
First Line : 101 S 10TH ST
Second Line :
City : RICHMOND
State : IN
Zip : 47374-5547
Country : US
Telephone Number : 765-966-1600
Fax Number : 765-962-9641
Authorized Official
Title or Position : PRESIDENT
Name : MR. CRAIG C. KINYON
Credential :
Telephone Number : 765-983-3122
Provider Enumeration Date : 02/14/2006
Last Update Date : 01/31/2014

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Directions to “REID PHYSICIAN ASSOCIATES, INC. ” Practice Location

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