1669472122 NPI number — JOHN REED JR. M.D.

Table of content: AUDRIUS V PLIOPLYS MD (NPI 1386639342)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669472122 NPI number — JOHN REED JR. M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REED
Provider First Name:
JOHN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
JR.
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669472122
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/14/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
75 REMITTANCE DR
Provider Second Line Business Mailing Address:
SUITE 6679
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60675-1001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-476-8646
Provider Business Mailing Address Fax Number:
919-382-3210

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 W 27TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUMBERTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28358-3075
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-737-3410
Provider Business Practice Location Address Fax Number:
910-737-3151
Provider Enumeration Date:
07/27/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  32840 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: D1493 . This is a "DR. REED'S MEDCOST #" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 70794 . This is a "BCBS OF NC GROUP # 015CK" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: P00107128 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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