Provider Demographics
NPI:1689649667
Name:BOUCHEY, REED MUNRO (MD PC)
Entity Type:Individual
Prefix:DR
First Name:REED
Middle Name:MUNRO
Last Name:BOUCHEY
Suffix:
Gender:M
Credentials:MD PC
Other - Prefix:
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Mailing Address - Street 1:501 S WHITE ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MT PLEASANT
Mailing Address - State:IA
Mailing Address - Zip Code:52641-2600
Mailing Address - Country:US
Mailing Address - Phone:319-385-6775
Mailing Address - Fax:319-385-6778
Practice Address - Street 1:501 S WHITE ST
Practice Address - Street 2:SUITE 105
Practice Address - City:MT PLEASANT
Practice Address - State:IA
Practice Address - Zip Code:52641-2600
Practice Address - Country:US
Practice Address - Phone:319-385-6775
Practice Address - Fax:319-385-6778
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2008-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA26041207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0100297Medicaid
IAI21632Medicare PIN
IA0100297Medicaid