Provider Demographics
NPI:1790992873
Name:REEVES, WILLIAM R (RPH, PHC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:R
Last Name:REEVES
Suffix:
Gender:M
Credentials:RPH, PHC
Other - Prefix:
Other - First Name:BILL
Other - Middle Name:
Other - Last Name:REEVES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH, PHC
Mailing Address - Street 1:465 SAINT MICHAELS DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7670
Mailing Address - Country:US
Mailing Address - Phone:505-913-5287
Mailing Address - Fax:505-913-4949
Practice Address - Street 1:455 SAINT MICHAELS DR
Practice Address - Street 2:ST. VINCENT HOSPITAL, ANTICOAGULATION MANAGEMENT SERVIC
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7601
Practice Address - Country:US
Practice Address - Phone:505-913-5287
Practice Address - Fax:505-913-4949
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM000000661835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy