Provider Demographics
NPI:1194927301
Name:REESE, FRANK EDWARD (OD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:EDWARD
Last Name:REESE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 HIGHWAY 8 EAST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732
Mailing Address - Country:US
Mailing Address - Phone:662-843-4011
Mailing Address - Fax:662-843-4011
Practice Address - Street 1:801 HIGHWAY 8 EAST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732
Practice Address - Country:US
Practice Address - Phone:662-843-4011
Practice Address - Fax:662-843-4011
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS446152W00000X
MS94012152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1194927301OtherBLUE CROSS BLUE SHIELD
MS625430OtherVCP
MS640725374OtherSUPERIORVISION
MS117634OtherEYEMED
MS00087760Medicaid
MS640725374OtherUNITEDHEALTHCARE
MS0143250001OtherPALMETTO
MS64725374OtherVSPCHIPS
MS560920549Medicare ID - Type Unspecified
MS0143250001OtherPALMETTO
MS640725374OtherSUPERIORVISION