Basic Information
| Provider Information | |||||||||
| NPI: | 1225020613 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BASKIN | ||||||||
| FirstName: | REED | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 405827 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303845800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | |||||||||
| FaxNumber: | 9012278591 | ||||||||
| Practice Location | |||||||||
| Address1: | 80 HUMPHREYS CENTER DR STE 330 | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381202363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017526131 | ||||||||
| FaxNumber: | 9017516170 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2005 | ||||||||
| LastUpdateDate: | 10/17/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | 5786 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RH0003X | 17885 | MS | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RH0003X | R4662 | AR | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 3155066 | 05 | TN | MEDICAID | 202906004 | 05 | MO | MEDICAID | 80402 | 01 | AR | BLUE CROSS BLUE SHIELD | OTHER | 4097638 | 01 | AETNA | OTHER | 6238834 | 01 | CIGNA | OTHER | 3161967 | 01 | TN | BLUE CROSS BLUE SHIELD | OTHER | 106896001 | 05 | AR | MEDICAID | 00123744 | 05 | MS | MEDICAID |