Provider Demographics
NPI:1992984488
Name:DON L REESE, MD, PC
Entity type:Organization
Organization Name:DON L REESE, MD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:L
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-272-3030
Mailing Address - Street 1:1377 E 3900 S STE 200
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1496
Mailing Address - Country:US
Mailing Address - Phone:801-272-3030
Mailing Address - Fax:801-277-6226
Practice Address - Street 1:1377 E 3900 S STE 200
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1496
Practice Address - Country:US
Practice Address - Phone:801-272-3030
Practice Address - Fax:801-277-6226
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DON L REESE, MD, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1645581205174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty