Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 01071907A | IN |
Y | 207RH0003X | Hematology & Oncology | 13167A | WY |
N | 207RX0202X | Medical Oncology | 01071907A | IN |
NPI | 1295742153 |
---|---|
Provider Name | Dr. Thomas Joseph Reid III |
First Address | Cody, WY 82414-3409 |
Second Address | Cody, WY 82414-3441 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 05/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000803315 | BCBS ONCOLOGY (01) | IN |
000000878541 | BCBS BMG LAPORTE (01) | IN |
000000879368 | BCBS HEMATOLOGY MEDIAL ONCOLOGY (01) | IN |
201131790 | (05) | IN |
P01253859 | RR MEDICARE (01) | IN |