Provider Demographics
NPI:1942394580
Name:REED, WILLIAM RAY (DC, PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RAY
Last Name:REED
Suffix:
Gender:M
Credentials:DC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 154
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-0154
Mailing Address - Country:US
Mailing Address - Phone:502-222-1897
Mailing Address - Fax:
Practice Address - Street 1:301 E JEFFERSON STREET
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031
Practice Address - Country:US
Practice Address - Phone:502-222-1897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4199111N00000X
IAA5731111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85001006Medicaid
KY000000050478OtherANTHEM BLUE CROSS/BLUE SH
KY1138593Medicaid
KY4535084OtherAETNA
KY000000050478OtherANTHEM BLUE CROSS/BLUE SH
KY6068301Medicare ID - Type UnspecifiedMEDICARE
KY85001006Medicaid