Provider Demographics
NPI:1619021086
Name:REES, JOHN WILLIAM JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILLIAM
Last Name:REES
Suffix:JR
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 1:611 FEDERAL ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MILTON
Mailing Address - State:DE
Mailing Address - Zip Code:19968-1157
Mailing Address - Country:US
Mailing Address - Phone:302-684-1995
Mailing Address - Fax:302-329-9743
Practice Address - Street 1:611 FEDERAL ST
Practice Address - Street 2:SUITE 5
Practice Address - City:MILTON
Practice Address - State:DE
Practice Address - Zip Code:19968-1157
Practice Address - Country:US
Practice Address - Phone:302-684-1995
Practice Address - Fax:302-329-9743
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000735111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE681138OtherUNITED HEALTH CARE ID
DEF1-0000735OtherLICENSE NUMBER
MDP00306715OtherMEDICARE RAILROAD ID
MD348400-06OtherCAREFIRST BCBS ID
DEF1-0000735OtherLICENSE NUMBER
MD238P514GMedicare ID - Type UnspecifiedMEDICARE ID