Provider Demographics
NPI:1467831396
Name:REEDER, CALLIE (MD)
Entity Type:Individual
Prefix:
First Name:CALLIE
Middle Name:
Last Name:REEDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 ALCOA HWY STE A435
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1520
Mailing Address - Country:US
Mailing Address - Phone:865-263-2400
Mailing Address - Fax:
Practice Address - Street 1:1924 ALCOA HWY # U-27
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1511
Practice Address - Country:US
Practice Address - Phone:865-305-9306
Practice Address - Fax:865-305-6822
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN65563207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ943331Medicaid
TN65563OtherSTATE MEDICAL LICENSE