Provider Demographics
NPI:1932915907
Name:REID, TIMOTHY JR
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:
Last Name:REID
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5315 KADE JOSEPH DR APT 205
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-8296
Mailing Address - Country:US
Mailing Address - Phone:614-622-0644
Mailing Address - Fax:
Practice Address - Street 1:5315 KADE JOSEPH DR APT 205
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-8296
Practice Address - Country:US
Practice Address - Phone:614-622-0644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-05
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No374U00000XNursing Service Related ProvidersHome Health Aide