Doctor Name: | MR. JAIME L REED |
NPI Number: | 1801041314 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | |
Business Practice Address: | 331 Sijen Ave Whiteman Afb, MO - 653051269 |
Business Phone Number: | 6606874908 |
Business Fax Number: | |
Mailing Address: | 331 Sijen Ave, WHITEMAN AFB |
State: | MO |
Postal Code: | 653051269 |
Phone Number: | 6606874908 |
Fax Number: | |
NPI Enumeration Date: | 11/25/2008 |
NPI Last Update Date: | 06/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |