Provider Demographics
NPI:1679856900
Name:REEVES, DELBERT CLAYTON (RPH)
Entity Type:Individual
Prefix:
First Name:DELBERT
Middle Name:CLAYTON
Last Name:REEVES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 N SERVICEBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-9794
Mailing Address - Country:US
Mailing Address - Phone:435-586-6941
Mailing Address - Fax:435-868-4136
Practice Address - Street 1:1948 W CROSS HOLLOW RD
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-8325
Practice Address - Country:US
Practice Address - Phone:435-868-4009
Practice Address - Fax:435-868-4136
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT151190-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist