Provider Demographics
NPI:1497023147
Name:REEVES SPINE AND ORTHOPEDIC,LLC
Entity Type:Organization
Organization Name:REEVES SPINE AND ORTHOPEDIC,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:870-741-8289
Mailing Address - Street 1:224 W. ERIE
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601
Mailing Address - Country:US
Mailing Address - Phone:870-741-8289
Mailing Address - Fax:870-741-0308
Practice Address - Street 1:224 W. ERIE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601
Practice Address - Country:US
Practice Address - Phone:870-741-8289
Practice Address - Fax:870-741-0308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE7280207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty