Provider Demographics
NPI:1053107185
Name:REED, SAMUEL TAYLOR (DC)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:TAYLOR
Last Name:REED
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:SAMUEL
Other - Middle Name:TAYLOR
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:212 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-3130
Mailing Address - Country:US
Mailing Address - Phone:479-524-5301
Mailing Address - Fax:
Practice Address - Street 1:212 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-3130
Practice Address - Country:US
Practice Address - Phone:479-524-5301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR12431111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor