Provider Demographics
NPI:1699760017
Name:REID, LAWRENCE H (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:H
Last Name:REID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 TUSCULUM BLVD
Mailing Address - Street 2:STE 1100
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4279
Mailing Address - Country:US
Mailing Address - Phone:423-787-7020
Mailing Address - Fax:423-787-7025
Practice Address - Street 1:1404 TUSCULUM BLVD
Practice Address - Street 2:STE 1100
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4279
Practice Address - Country:US
Practice Address - Phone:423-787-7020
Practice Address - Fax:423-787-7025
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000007105207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3046612OtherBCBS #
TN1539546OtherUMWA #
TN62166246601OtherJOHN DEERE #
TN1539546OtherUMWA #
TN62166246601OtherJOHN DEERE #