Provider Demographics
NPI:1487624243
Name:REED, JAMES D (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:REED
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:4121 OKEMOS RD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-3220
Mailing Address - Country:US
Mailing Address - Phone:517-381-1700
Mailing Address - Fax:517-381-1703
Practice Address - Street 1:4121 OKEMOS RD
Practice Address - Street 2:SUITE 15
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3220
Practice Address - Country:US
Practice Address - Phone:517-381-1700
Practice Address - Fax:517-381-1703
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6301005840103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI61-39094OtherUBH
MI61-93909OtherPHP
MI367325OtherTRICARE/MHN
MI680C3141520OtherBCBS
MI7670553OtherAETNA PROVIDER
MI037190OtherVALUE OPTIONS
MI367325OtherTRICARE/MHN