Provider Demographics
NPI:1659350049
Name:REESE, DON L (MD)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:L
Last Name:REESE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:999 MURRAY HOLLADAY RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-4901
Mailing Address - Country:US
Mailing Address - Phone:801-268-2584
Mailing Address - Fax:801-262-1168
Practice Address - Street 1:999 MURRAY HOLLADAY RD
Practice Address - Street 2:SUITE 207
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-4901
Practice Address - Country:US
Practice Address - Phone:801-268-2584
Practice Address - Fax:801-262-1168
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2012-02-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT164558-1205207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD07365Medicare UPIN
UT005733601Medicare ID - Type Unspecified