Individual
DR. CHARLES TYLER REIDHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 W. HOSPITAL DRIVE, WHITERIVER, AZ 85941
(928) 338-4911
(928) 338-1122
Mailing address
PO BOX 860, WHITERIVER, AZ 85941-0860
(928) 338-4911
(928) 338-1122
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25107
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295993376
—
AZ
05
—
1629236716
—
AZ
05
—
1780614008
—
AZ
05
—
1871523191
—
AZ
05
—
409856
—
AZ
Enumeration date
08/01/2006
Last updated
12/15/2008
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