Individual
LARRY D REED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 MAPLE SUMMIT RD, JERSEYVILLE, IL 62052-2028
(618) 498-6402
Mailing address
36 GARDEN CTR, BROOMFIELD, CO 80020-1730
(303) 465-0401
(303) 438-1351
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036073586
IL
2085R0202X
Diagnostic Radiology Physician
R2D52
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036073586-1
—
IL
05
—
036073586-2
—
IL
05
—
202107736
—
MO
01
—
IL4399005
MEDICARE
IL
Enumeration date
03/27/2006
Last updated
04/20/2016
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