Provider Demographics
NPI:1255336335
Name:REECE, RICHARD L JR (DO)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:REECE
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:DEPT 888163
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37995-8163
Mailing Address - Country:US
Mailing Address - Phone:276-325-0678
Mailing Address - Fax:558-580-4648
Practice Address - Street 1:430 MAIN ST W
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:WV
Practice Address - Zip Code:25901-3414
Practice Address - Country:US
Practice Address - Phone:304-469-8600
Practice Address - Fax:855-858-0464
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101013578208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1255336335Medicaid
MI70-0-F32947-0OtherBCBS CPIN #
MIP28070130Medicare PIN
MIH15907Medicare UPIN