Individual
JACK REID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 E MCDOWELL RD, PHOENIX, AZ 85006-2612
(480) 478-8057
Mailing address
286 S SENECA CIR # 51, ANAHEIM, CA 92805-3655
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
71487
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/21/2019
Last updated
03/08/2024
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