Provider Demographics
NPI:1801025630
Name:REED, PETER JEFFREY (DO)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:JEFFREY
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 1:14045 N 7TH ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-4387
Mailing Address - Country:US
Mailing Address - Phone:602-795-5505
Mailing Address - Fax:602-795-9277
Practice Address - Street 1:14045 N 7TH ST
Practice Address - Street 2:SUITE 3
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-4387
Practice Address - Country:US
Practice Address - Phone:602-795-5505
Practice Address - Fax:602-795-9277
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLL18366207Q00000X
AZ005940207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine