MEDICARE: DR. ANDREW J REED PH.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
1	103TC0700X	Clinical Psychologist	20040384	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	680014742	OTHER	IN	RR MCARE PRIVATE PRACTICE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	360003673	OTHER	IN	RR MCARE THERAPY

General Provider Information

NPI Number	:	1194788133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW J REED PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 15040
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47716-0040
Country	:	US
Telephone Number	:	812-476-1367
Fax Number	:	812-477-4153

Provider Business Practice Location Address
First Line	:	6221 PHYSICIANS CT
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-4031
Country	:	US
Telephone Number	:	812-454-5457
Fax Number	:	812-471-9282

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

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	09/15/2008

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