Provider Demographics
NPI:1497937981
Name:PAUL E REED OD PC
Entity Type:Organization
Organization Name:PAUL E REED OD PC
Other - Org Name:REED EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:801-731-5558
Mailing Address - Street 1:1761 N 2000 W
Mailing Address - Street 2:
Mailing Address - City:FARR WEST
Mailing Address - State:UT
Mailing Address - Zip Code:84404-9541
Mailing Address - Country:US
Mailing Address - Phone:801-731-5558
Mailing Address - Fax:801-731-3143
Practice Address - Street 1:1761 N 2000 W
Practice Address - Street 2:
Practice Address - City:FARR WEST
Practice Address - State:UT
Practice Address - Zip Code:84404-9541
Practice Address - Country:US
Practice Address - Phone:801-731-5558
Practice Address - Fax:801-731-3143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3694249934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5274440001Medicare NSC