Provider Demographics
NPI:1497957526
Name:REYES, HUBERT S (MD)
Entity Type:Individual
Prefix:DR
First Name:HUBERT
Middle Name:S
Last Name:REYES
Suffix:
Gender:M
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:PO BOX 13059
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4021
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2345 W FRANKLIN ST STE 102
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-5100
Practice Address - Country:US
Practice Address - Phone:812-270-9903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01063402A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200865060Medicaid
IN237890Medicare ID - Type UnspecifiedMEDICARE GRP #
IN250470PMedicare PIN
IN237890FFMedicare PIN
IN000000548961OtherANTHEM PIN
KY7100018040Medicaid
INDF3251OtherRR MEDICARE GRP#
INP00412975OtherRAILROAD INDIVIDUAL
IN000000525218OtherANTHEM PIN
IN250470OtherMEDICARE GROUP