Basic Information
| Provider Information | |||||||||
| NPI: | 1033250857 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | REESE FAMILY HEALTHCARE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3025 BRECKINRIDGE BLVD | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | DULUTH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300967611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6782260082 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 TREMON ST | ||||||||
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| City: | GORDON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 310315013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4786281515 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2007 | ||||||||
| LastUpdateDate: | 12/05/2007 | ||||||||
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| AuthorizedOfficialLastName: | REESE | ||||||||
| AuthorizedOfficialFirstName: | MORRIS | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4786281515 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 040769 | GA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.