Provider Demographics
NPI:1588013759
Name:REED, GAVIN TANNER (MD)
Entity Type:Individual
Prefix:
First Name:GAVIN
Middle Name:TANNER
Last Name:REED
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2101 HIGHLAND AVE S STE 350
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-4009
Mailing Address - Country:US
Mailing Address - Phone:205-558-2525
Mailing Address - Fax:205-558-2554
Practice Address - Street 1:401 MERIDIAN ST N STE 400
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4719
Practice Address - Country:US
Practice Address - Phone:256-539-8851
Practice Address - Fax:256-534-7203
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALMD.43949207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALMD.43949OtherAL MEDICAL LICENSE