Provider Demographics
NPI:1710982079
Name:REED, RONALD KIRBY (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:KIRBY
Last Name:REED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 S MARYLAND PKWY
Mailing Address - Street 2:STE 460
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-2235
Mailing Address - Country:US
Mailing Address - Phone:702-733-2074
Mailing Address - Fax:702-733-2075
Practice Address - Street 1:3006 S MARYLAND PKWY
Practice Address - Street 2:STE 460
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2235
Practice Address - Country:US
Practice Address - Phone:702-733-2074
Practice Address - Fax:702-733-2075
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV37332084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2002226Medicaid
NVC96493Medicare UPIN