Individual
TYLER JACOB REED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
1701 N SENATE AVE, INDIANAPOLIS, IN 46202-5306
(317) 274-0275
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
75000108A
IN
367H00000X
Anesthesiologist Assistant
PENDING
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001654899
ANTHEM PTAN
IN
Enumeration date
06/23/2021
Last updated
12/02/2024
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