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NPI Code Detail

MEDICARE: BENJAMIN H REECE PA

MEDICARE: BENJAMIN H REECE PA
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
1363A00000XPhysician AssistantPA.0006639CO
2390200000XStudent in an Organized Health Care Education/Training Program
3363A00000XPhysician Assistant7127124-1206UT

General Provider Information

NPI Number : 1336740505
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN H REECE PA
Provider Business Mailing Address
First Line : 250 W 300 N
Second Line :
City : ROOSEVELT
State : UT
Zip : 84066-2351
Country : US
Telephone Number : 435-725-7448
Fax Number : 435-722-9291
Provider Business Practice Location Address
First Line : 250 W 300 N
Second Line :
City : ROOSEVELT
State : UT
Zip : 84066-2351
Country : US
Telephone Number : 435-722-6163
Fax Number : 435-722-9291
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2020
Last Update Date : 01/29/2025

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Directions to “ BENJAMIN H REECE PA” Practice Location

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