Provider Demographics
NPI:1922267442
Name:REECE, CYNTHIA KAREN (DO)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:KAREN
Last Name:REECE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:KAREN
Other - Last Name:EGLESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3614 UNICOI DR # A
Mailing Address - Street 2:
Mailing Address - City:UNICOI
Mailing Address - State:TN
Mailing Address - Zip Code:37692-6860
Mailing Address - Country:US
Mailing Address - Phone:423-270-2145
Mailing Address - Fax:423-270-2146
Practice Address - Street 1:3614 UNICOI DR # A
Practice Address - Street 2:
Practice Address - City:UNICOI
Practice Address - State:TN
Practice Address - Zip Code:37692-6860
Practice Address - Country:US
Practice Address - Phone:423-270-2145
Practice Address - Fax:423-270-2146
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TND02208207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1522824Medicaid
TN10370G6046Medicare UPIN
TN103I088907Medicare PIN