Basic Information
| Provider Information | |||||||||
| NPI: | 1801996756 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REYER | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | ALLAN | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 116 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | LEECHBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156561333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7248451211 | ||||||||
| FaxNumber: | 7248455465 | ||||||||
| Practice Location | |||||||||
| Address1: | 116 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | LEECHBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156561333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7248451211 | ||||||||
| FaxNumber: | 7248455465 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 04/12/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS012307 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1633283 | 01 | PA | BLUE SHIELD | OTHER | 703421 | 01 | PA | UPMC | OTHER | 1010552490001 | 05 | PA | MEDICAID | 5318701 | 01 | PA | CIGNA | OTHER | P006131 | 01 | PA | GATEWAY | OTHER | 197431 | 01 | PA | UNISON | OTHER | 2434195 | 01 | PA | UNITED HEALTHCARE | OTHER | 7158534 | 01 | PA | AETNA | OTHER | P00400335 | 01 | PA | RR MCR | OTHER |