Provider Demographics
NPI:1528103660
Name:WILLIAM U REEVES OD INC
Entity type:Organization
Organization Name:WILLIAM U REEVES OD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:URQUHART
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-678-8079
Mailing Address - Street 1:143 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-2524
Mailing Address - Country:US
Mailing Address - Phone:330-678-8079
Mailing Address - Fax:
Practice Address - Street 1:143 E MAIN ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-2524
Practice Address - Country:US
Practice Address - Phone:330-678-8079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2960152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0154685Medicaid
OHT46227Medicare UPIN
OHRE0370391Medicare ID - Type Unspecified