Individual
JERI ROBERTA REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1930 BISHOP LN, SUITE 1600, LOUISVILLE, KY 40218-1921
(502) 272-5034
(502) 272-5117
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25776
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200340860
—
IN
05
—
64257769
—
KY
Enumeration date
10/11/2005
Last updated
07/09/2016
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