Provider Demographics
NPI:1023360658
Name:REED, JARED S (PA)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:S
Last Name:REED
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:2500 CANTERBURY DR
Mailing Address - Street 2:SUITE 112
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2247
Mailing Address - Country:US
Mailing Address - Phone:785-261-7599
Mailing Address - Fax:785-628-3264
Practice Address - Street 1:2500 CANTERBURY DR
Practice Address - Street 2:SUITE 112
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2247
Practice Address - Country:US
Practice Address - Phone:785-261-7599
Practice Address - Fax:785-628-3264
Is Sole Proprietor?:No
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS1501573363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSPENDINGMedicaid