Organization
BEN A REID JR PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEN A REID JR. MD (SOLE MEMBER OWNER)
(502) 361-6070
Entity
Organization
Contact information
Practice address
4402 CHURCHMAN AVE, SUITE 211, LOUISVILLE, KY 40215-1190
(502) 361-6070
(502) 363-7811
Mailing address
4402 CHURCHMAN AVE, SUITE 211, LOUISVILLE, KY 40215-1190
(502) 361-6070
(502) 363-7811
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
14503
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000046091
ANTHEM
KY
01
—
1059433
PASSPORT
KY
01
—
1780036
UNITED HEALTHCARE
—
01
—
2434094000
PASSPORT ADVANTAGE
KY
05
—
641145039
—
KY
Enumeration date
10/24/2006
Last updated
02/24/2009
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