Herman L. Reid III MD LLC
Organization Active NPI Specialist · Fort Branch, IN
NPI 1942585963 · NPPES record last updated Mar 2, 2015
Key facts
- NPI
- 1942585963
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 01056394A (IN)
- Legal business name
- HERMAN L. REID III MD LLC
- Practice address
- 7839 S Professional Dr
Fort Branch, IN 47648-8405 - Phone
- (812) 306-6631
- Fax
- (812) 867-6951
- NPI assigned
- Oct 21, 2011
- Organization subpart
- No
Authorized official
- Name
- Mrs. Maria E Penn-Reid, BA
- Title
- Office Manager
- Phone
- (812) 306-6631
National Provider Directory
Locations
7839 S Professional Dr
#L
Fort Branch, IN 47648
Phone (812) 753-5903
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 01056394A | IN | Yes |
Addresses
Primary practice location
7839 S Professional Dr
Fort Branch, IN 47648-8405
Mailing address
18920 Roscommon Rd
Evansville, IN 47725-6417
Phone (812) 306-6631
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200389450 | Medicaid | IN | |
| 201228280 | Medicaid | IN | |
| XXXXX3397 | Medicaid | IL |
Other providers in Fort Branch, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2015. 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.