Provider Demographics
NPI:1598869661
Name:REED, JEFFREY DWAYNE (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:DWAYNE
Last Name:REED
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 VILLAGE PLAZA WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1849
Mailing Address - Country:US
Mailing Address - Phone:401-934-0077
Mailing Address - Fax:401-934-2960
Practice Address - Street 1:6 VILLAGE PLAZA WAY
Practice Address - Street 2:
Practice Address - City:NORTH SCITUATE
Practice Address - State:RI
Practice Address - Zip Code:02857-1849
Practice Address - Country:US
Practice Address - Phone:401-934-0077
Practice Address - Fax:401-934-2960
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP000326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
400290OtherBLUE CHIP
720091301OtherCIGNA
9035OtherBLUE CROSS
AA15022OtherHARVARD
4400257OtherUNITED HLTH
720091301OtherCIGNA
RIU35306Medicare UPIN