Provider Demographics
NPI:1093826349
Name:REED, DAVID ALAN (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALAN
Last Name:REED
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:ALAN
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:860 S MADISON ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-4905
Mailing Address - Country:US
Mailing Address - Phone:662-377-7150
Mailing Address - Fax:662-377-7155
Practice Address - Street 1:860 S MADISON ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-4905
Practice Address - Country:US
Practice Address - Phone:662-377-7150
Practice Address - Fax:662-377-7155
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS17162207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS512I290013Medicare PIN