Provider Demographics
NPI:1689720690
Name:REATH, DAVID B (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:REATH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:109 S NORTHSHORE DR
Mailing Address - Street 2:STE. 101
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4939
Mailing Address - Country:US
Mailing Address - Phone:865-450-9253
Mailing Address - Fax:865-450-9949
Practice Address - Street 1:109 S NORTHSHORE DR
Practice Address - Street 2:STE. 101
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4939
Practice Address - Country:US
Practice Address - Phone:865-450-9253
Practice Address - Fax:865-450-9949
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
TNMD17083208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty