Basic Information
| Provider Information | |||||||||
| NPI: | 1871589838 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REEDER | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 250 S CRESCENT DR | ||||||||
| Address2: | |||||||||
| City: | MASON CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 504012926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6414945400 | ||||||||
| FaxNumber: | 6414945403 | ||||||||
| Practice Location | |||||||||
| Address1: | 250 S CRESCENT DR | ||||||||
| Address2: | |||||||||
| City: | MASON CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 504012926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6414945300 | ||||||||
| FaxNumber: | 6414945321 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2005 | ||||||||
| LastUpdateDate: | 01/24/2018 | ||||||||
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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 | 207RC0000X | 2005 | IA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | DO-02005 | IA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 3211219 | 05 | IA | MEDICAID |