Provider Demographics
NPI:1962731067
Name:REED MATHIS, D.C.
Entity type:Organization
Organization Name:REED MATHIS, D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:REED
Authorized Official - Last Name:MATHIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-942-4115
Mailing Address - Street 1:1291 CEDAR CENTER DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-4877
Mailing Address - Country:US
Mailing Address - Phone:850-942-4115
Mailing Address - Fax:850-942-4118
Practice Address - Street 1:1291 CEDAR CENTER DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-4877
Practice Address - Country:US
Practice Address - Phone:850-942-4115
Practice Address - Fax:850-942-4118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-18
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7697111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
55861OtherBCBS
FL55861Medicare UPIN