Provider Demographics
NPI:1255463311
Name:REED, BEATRICE (OD)
Entity type:Individual
Prefix:DR
First Name:BEATRICE
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5506 W MARKHAM ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3412
Mailing Address - Country:US
Mailing Address - Phone:501-663-1131
Mailing Address - Fax:501-663-1413
Practice Address - Street 1:5506 W MARKHAM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3412
Practice Address - Country:US
Practice Address - Phone:501-663-1131
Practice Address - Fax:501-663-1413
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2374152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR47809Medicare ID - Type Unspecified