Provider Demographics
NPI:1073793535
Name:DR. PHILIP . REED, DC
Entity Type:Organization
Organization Name:DR. PHILIP . REED, DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:580-234-0166
Mailing Address - Street 1:721 S OAKWOOD RD
Mailing Address - Street 2:STE A
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-6247
Mailing Address - Country:US
Mailing Address - Phone:580-234-0166
Mailing Address - Fax:580-234-2766
Practice Address - Street 1:721 S OAKWOOD RD
Practice Address - Street 2:STE A
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-6247
Practice Address - Country:US
Practice Address - Phone:580-234-0166
Practice Address - Fax:580-234-2766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3089111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK900522351Medicare PIN