MEDICARE: DR. JOHN E REEVES OD

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	152W00000X	Optometrist	788	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	003250004	OTHER	OR	REGENCE BLUE CROSS BLUE

General Provider Information

NPI Number	:	1801867544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN E REEVES OD

Provider Business Mailing Address
First Line	:	1211 5TH ST S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405
Country	:	US
Telephone Number	:	406-761-6841
Fax Number	:	406-454-0609

Provider Business Practice Location Address
First Line	:	1211 5TH ST S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-4304
Country	:	US
Telephone Number	:	406-761-6841
Fax Number	:	406-454-0609

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

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	01/31/2018

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Directions to “ DR. JOHN E REEVES OD” Practice Location

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