Provider Demographics
NPI:1487619664
Name:REED, PAUL D (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:REED
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:OK
Mailing Address - Zip Code:73651-4010
Mailing Address - Country:US
Mailing Address - Phone:580-726-2900
Mailing Address - Fax:
Practice Address - Street 1:116 W 4TH ST
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:OK
Practice Address - Zip Code:73651-4010
Practice Address - Country:US
Practice Address - Phone:580-726-2900
Practice Address - Fax:580-726-5568
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3219111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU55160Medicare UPIN