Individual
RENETTA REEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4500 S 129TH EAST AVE, SUITE 191, TULSA, OK 74134-5801
(800) 993-8244
Mailing address
4500 S 129TH EAST AVE, SUITE 191, TULSA, OK 74134-5801
(800) 993-8244
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16980
OK
207QA0505X
Adult Medicine Physician
ME 62145
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17769Z
MEDICARE PTAN
FL
Enumeration date
12/17/2008
Last updated
04/23/2015
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