Basic Information
| Provider Information | |||||||||
| NPI: | 1245586700 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | REID PHYSICIAN ASSOCIATES, INC | ||||||||
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| OtherOrganizationName: | HAGERSTOWN FAMILY PRACTICE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 REID PKWY | ||||||||
| Address2: | MEDICAL STAFF SERVICES | ||||||||
| City: | RICHMOND | ||||||||
| State: | IN | ||||||||
| PostalCode: | 473741157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7659833127 | ||||||||
| FaxNumber: | 7659833219 | ||||||||
| Practice Location | |||||||||
| Address1: | 4829 N STATE ROAD 1 | ||||||||
| Address2: | |||||||||
| City: | HAGERSTOWN | ||||||||
| State: | IN | ||||||||
| PostalCode: | 473469620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7654893935 | ||||||||
| FaxNumber: | 7654896344 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2012 | ||||||||
| LastUpdateDate: | 11/21/2013 | ||||||||
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| AuthorizedOfficialLastName: | HUTH | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7659833202 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | IN | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.