Provider Demographics
NPI:1437104338
Name:DONALD J. REED, M.D.
Entity type:Organization
Organization Name:DONALD J. REED, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:D
Authorized Official - Last Name:VIDRINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-235-6211
Mailing Address - Street 1:600 E GLORIA SWITCH RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70507-2512
Mailing Address - Country:US
Mailing Address - Phone:337-235-6211
Mailing Address - Fax:337-235-0852
Practice Address - Street 1:600 E GLORIA SWITCH RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-2512
Practice Address - Country:US
Practice Address - Phone:337-235-6211
Practice Address - Fax:337-235-0852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA013834173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1170984Medicaid
LA54856Medicare ID - Type Unspecified
LA1170984Medicaid