Basic Information
Provider Information
NPI: 1336133800
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REED
FirstName: TIMOTHY
MiddleName: T
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1626
Address2:  
City: OCALA
State: FL
PostalCode: 344781626
CountryCode: US
TelephoneNumber: 3528730516
FaxNumber: 3528739726
Practice Location
Address1: 1431 SW 1ST AVE
Address2:  
City: OCALA
State: FL
PostalCode: 344744000
CountryCode: US
TelephoneNumber: 3524011000
FaxNumber: 3528739726
Other Information
ProviderEnumerationDate: 09/09/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XME84184FLY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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