Provider Demographics
NPI:1477179869
Name:REID, STEPHEN AARON
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:AARON
Last Name:REID
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7521 MCFRENCH DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-9227
Mailing Address - Country:US
Mailing Address - Phone:843-743-9072
Mailing Address - Fax:
Practice Address - Street 1:GENERAL LEONARD WOOD COMMUNITY HOSPITAL
Practice Address - Street 2:4430 MISSOURI AVE
Practice Address - City:FORT LEONARD WOOD
Practice Address - State:AA
Practice Address - Zip Code:65473
Practice Address - Country:US
Practice Address - Phone:843-743-9072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program