Jack R Reid Jr MD LLC
Organization Active NPI Family Medicine Physician · Walker, LA
NPI 1356538433 · NPPES record last updated Apr 30, 2020
Key facts
- NPI
- 1356538433
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- JACK R REID JR MD LLC
- Practice address
- 5000 Odonavan Blvd Ste 307
Walker, LA 70785-6355 - Phone
- (225) 791-3117
- Fax
- (225) 791-3122
- NPI assigned
- Oct 2, 2007
- Organization subpart
- No
Authorized official
- Name
- Jack R Reid, MD
- Title
- Owner
- Phone
- (225) 791-3117
National Provider Directory
Locations
1585 S Range Ave
Ste 100
Denham Springs, LA 70726
Phone (225) 791-3117
5000 Odonavan Blvd
Ste 307
Walker, LA 70785
Phone (225) 791-3117
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
5000 Odonavan Blvd Ste 307
Walker, LA 70785-6355
Mailing address
PO Box 68
Oklahoma City, OK 73101-0068
Phone (225) 791-3117
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G5769 | Other | LA | BCBS |
| DF0604 | Other | LA | RAILROAD MCARE |
Other providers in Walker, LA
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- Emily Patrice Irvin
- Phyllis Jackson
- Cheryl Jeane
- Nicole Futch Jenks
- Hannah Jones
- Shyanne Rainelle Jones
All providers in Walker, LA · Family Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.