Provider Demographics
NPI:1770669129
Name:REED, PAUL MICHAEL (DO)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:MICHAEL
Last Name:REED
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1827
Mailing Address - Street 2:REED FAMILY CLINIC
Mailing Address - City:GUYMON
Mailing Address - State:OK
Mailing Address - Zip Code:73942-1827
Mailing Address - Country:US
Mailing Address - Phone:580-338-8338
Mailing Address - Fax:580-338-8340
Practice Address - Street 1:1309 N EAST STREET
Practice Address - Street 2:REED FAMILY CLINIC
Practice Address - City:GUYMON
Practice Address - State:OK
Practice Address - Zip Code:73942-1827
Practice Address - Country:US
Practice Address - Phone:580-338-8338
Practice Address - Fax:580-338-8340
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK3382207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100195120AMedicaid
G43618Medicare UPIN