Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 24101 | MS |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 58662 | MN |
NPI | 1285639955 |
---|---|
Provider Name | Lori Kay Reed |
First Address | Jackson, MS 39216-4500 |
Second Address | Jackson, MS 39216-4500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2005 |
Last Update Date | 04/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05826531 | (05) | MS |
269922200 | (05) | FL |
I10988 | (02) | FL |