Marilou Reyes, MD
Individual provider Active NPI Pediatrics Physician · Bullhead City, AZ
NPI 1972597441 · NPPES record last updated Jan 6, 2014
Key facts
- NPI
- 1972597441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 28997 (AZ)
- Practice address
- 2585 Miracle Mile
Suite 126
Bullhead City, AZ 86442-7522 - Phone
- (928) 763-7020
- Fax
- (928) 763-7050
- NPI assigned
- Sep 9, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arizona Institute of Medicine and Surgery | Past | Accepting new patients | |
| Aims Physicians and Surgeons | Pediatrics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 28997 | AZ | Yes |
Addresses
Primary practice location
2585 Miracle Mile
Suite 126
Bullhead City, AZ 86442-7522
Mailing address
PO Box 23245
Bullhead City, AZ 86439-3245
Phone (928) 763-7020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 787434 | Medicaid | AZ |
Other providers in Bullhead City, AZ
- Maranda Grace Sorensen Renouard
- Rescare Arizona, Inc.
- Resilient Minds Psychiatry PLLC
- Resilient Minds Psychiatry PLLC
- Sandra Reyes-Mendoza
- Claudette Rhoades
- Deana Marie Rhoads
- Richard Bailey, M.D., L.L.C
- James A. Richardson
- Russell Rima
All providers in Bullhead City, AZ · Pediatrics Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2014. 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.