MEDICARE: STEPHANIE T. REESE D.O.

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	207Q00000X	Family Medicine Physician	OT013508	PA

General Provider Information

NPI Number	:	1528379070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE T. REESE D.O.

Provider Business Mailing Address
First Line	:	PO BOX 818
Second Line	:
City	:	SPRINGFIELD
State	:	GA
Zip	:	31329-0818
Country	:	US
Telephone Number	:	912-826-5239
Fax Number	:	912-826-5237

Provider Business Practice Location Address
First Line	:	2100 RIVEREDGE PKWY STE 5005TH
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-4693
Country	:	US
Telephone Number	:	657-400-5180
Fax Number	:

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

Provider Enumeration Date	:	06/30/2010
Last Update Date	:	03/22/2023

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