Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 27576 | AZ |
N | 207PE0004X | Emergency Medical Services | 01041815 | IN |
NPI | 1013970375 |
---|---|
Provider Name | John M. Reid |
First Address | Tucson, AZ 85711 |
Second Address | Tucson, AZ 85745-2623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2006 |
Last Update Date | 20/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000181689 | ANTHEM (01) | IN |
104340092 | (05) | MI |
200005370A | (05) | IN |
930101006 | RAIL ROAD MEDICARE (01) | IN |
F93040 | (02) | IN |