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ROBERT BRADLEY REEVES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
201 W VAN ASCHE LOOP, FAYETTEVILLE, AR 72703-4996
(479) 966-4491
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
100174
MO
207X00000X
Orthopaedic Surgery Physician
7623
SD
207X00000X
Orthopaedic Surgery Physician
Primary
C-7011
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100135410B
KS
01
11464
ANTHEM
MO
01
200033678
RR MEDICARE
05
203311006
MO
Enumeration date
07/21/2006
Last updated
02/23/2021
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