Provider Demographics
NPI:1649250499
Name:REESE, HEWITT WILLIAM (DPM)
Entity type:Individual
Prefix:DR
First Name:HEWITT
Middle Name:WILLIAM
Last Name:REESE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:13660 N 94TH DR
Mailing Address - Street 2:F1
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4836
Mailing Address - Country:US
Mailing Address - Phone:623-933-1373
Mailing Address - Fax:623-933-5787
Practice Address - Street 1:13660 N 94TH DR
Practice Address - Street 2:F1
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4836
Practice Address - Country:US
Practice Address - Phone:623-933-1373
Practice Address - Fax:623-933-5787
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ0099213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZT42068Medicare UPIN