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Individual

JULIA ERIN REID

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2300 W STONE DR, KINGSPORT, TN 37660-2360
(423) 246-4961
(423) 245-3136
Mailing address
2300 W STONE DR, KINGSPORT, TN 37660-2360
(423) 246-4961
(423) 245-3136

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
125-053205
IL
207ND0101X
MOHS-Micrographic Surgery Physician
036-127825
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036127825
IL
05
1295927721
VA
Enumeration date
08/17/2007
Last updated
07/31/2012
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