Individual
MR. DENNIS REED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
314 E MAIN ST, PORTAGEVILLE, MO 63873-1616
(573) 379-3777
(573) 379-9331
Mailing address
1008 N MAIN ST, SIKESTON, MO 63801-5044
(573) 472-7406
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
DA 105031
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105031
PHYSICIANS ASSISTANT LICENSE
MO
Enumeration date
01/31/2007
Last updated
03/17/2018
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