Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 0074R | OK |
NPI | 1013380021 |
---|---|
Provider Name | Dr. Olivia Danielle Reed |
First Address | Guthrie, OK 73044-8113 |
Second Address | Norman, OK 73071-6404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2015 |
Last Update Date | 12/11/2015 |