MEDICARE: DR. JEFF SCOTT REID 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	207L00000X	Anesthesiology Physician	4551	OK

General Provider Information

NPI Number	:	1780718981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFF SCOTT REID D.O.

Provider Business Mailing Address
First Line	:	17413 HAWKS VIEW CT
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73012-0605
Country	:	US
Telephone Number	:	580-272-0485
Fax Number	:	580-332-5750

Provider Business Practice Location Address
First Line	:	14000 N PORTLAND AVE STE 100
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-4004
Country	:	US
Telephone Number	:	405-936-8100
Fax Number	:	580-332-5750

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

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	04/26/2023

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