MEDICARE: DR. ERIN P REILLY 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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	MD18391	OR
2	207Q00000X	Family Medicine Physician	31525	SC
3	207Q00000X	Family Medicine Physician	MD18391	OR

Other Identifiers

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

General Provider Information

NPI Number	:	1285602086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIN P REILLY MD

Provider Business Mailing Address
First Line	:	1520 KNOX AVE
Second Line	:
City	:	NORTH AUGUSTA
State	:	SC
Zip	:	29841-4010
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	860 BELTLINE RD
Second Line	:
City	:	SPRINGFIELD
State	:	OR
Zip	:	97477-1091
Country	:	US
Telephone Number	:	541-222-6005
Fax Number	:	541-222-6029

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	01/23/2020

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Directions to “ DR. ERIN P REILLY MD” Practice Location

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