| Jack R Reid Jr Md Llc | |
|
5000 Odonavan Blvd Ste 307 Walker LA 70785-6355 | |
| (225) 791-3117 | |
| (225) 791-3122 |
| Full Name | Jack R Reid Jr Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5000 Odonavan Blvd Ste 307, Walker, Louisiana |
| Authorized Official Name and Position | Jack R Reid (OWNER) |
| Authorized Official Contact | 2257913117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack R Reid Jr Md Llc Po Box 68 Oklahoma City OK 73101-0068 Ph: (225) 791-3117 | Jack R Reid Jr Md Llc 5000 Odonavan Blvd Ste 307 Walker LA 70785-6355 Ph: (225) 791-3117 |
| NPI Number | 1356538433 |
|---|---|
| Provider Enumeration Date | 10/02/2007 |
| Last Update Date | 04/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356538433 | NPI | - | NPPES |
| G5769 | Other | LA | BCBS |
| DF0604 | Other | LA | RAILROAD MCARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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