Provider Demographics
NPI:1639376932
Name:JOHN L. REED M.D. SURGICAL PRACTICE, P.C.
Entity Type:Organization
Organization Name:JOHN L. REED M.D. SURGICAL PRACTICE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-483-1991
Mailing Address - Street 1:8055 O STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2580
Mailing Address - Country:US
Mailing Address - Phone:402-421-0896
Mailing Address - Fax:402-421-0945
Practice Address - Street 1:8055 O ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2564
Practice Address - Country:US
Practice Address - Phone:402-421-0896
Practice Address - Fax:402-421-0945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10719208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1700437OtherUHC
IA0591669Medicaid
SD7719030Medicaid
NE10025532000Medicaid
NE1226OtherMIDLANDS CHOICE
NE35824OtherBCBS
NE1226OtherMIDLANDS CHOICE
NE10025532000Medicaid