Provider Demographics
NPI:1053656801
Name:REID PHYSICIAN ASSOCIATES INC
Entity Type:Organization
Organization Name:REID PHYSICIAN ASSOCIATES INC
Other - Org Name:REID ORTHOPEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-983-3421
Mailing Address - Street 1:1100 REID PKWY
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1157
Mailing Address - Country:US
Mailing Address - Phone:765-983-3127
Mailing Address - Fax:765-983-3219
Practice Address - Street 1:716 SWEITZER ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1072
Practice Address - Country:US
Practice Address - Phone:765-935-8905
Practice Address - Fax:765-935-8906
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REID PHYSICIAN ASSOCIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-05
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1053656801OtherDME
OH1053656801OtherDME