Provider Demographics
NPI:1801830443
Name:REED, DOUGLAS R (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:R
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 1:320 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17554-1232
Mailing Address - Country:US
Mailing Address - Phone:717-285-7121
Mailing Address - Fax:717-285-5302
Practice Address - Street 1:1000 COMMERCE PARK DR
Practice Address - Street 2:SUITE 110
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-5475
Practice Address - Country:US
Practice Address - Phone:570-323-6944
Practice Address - Fax:570-323-4529
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2017-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD47624L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA977004OtherPA BLUE SHIELD
PA001705449Medicaid
PA50037494OtherCAPITAL BLUE CROSS
PA001705449Medicaid
PA977004OtherPA BLUE SHIELD