Provider Demographics
NPI:1770530172
Name:REED, GEORGE BURTON III (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:BURTON
Last Name:REED
Suffix:III
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 942
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:GA
Mailing Address - Zip Code:30752-0942
Mailing Address - Country:US
Mailing Address - Phone:706-657-2700
Mailing Address - Fax:706-657-7965
Practice Address - Street 1:12138 S MAIN ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:GA
Practice Address - Zip Code:30752-5151
Practice Address - Country:US
Practice Address - Phone:706-657-2700
Practice Address - Fax:706-657-7965
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT001369225100000X
TNPT0000000626225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6109965001OtherCIGNA
GAON94573OtherUNITED HEALTHCARE OF GA
GA5100496100OtherBCBSGA
GA51001755001OtherBCBSGA
TN62-1407143OtherTAX ID NUMBER
GA51001755001OtherBCBSGA
GA62-1407143OtherTAX ID NUMBER