Individual
JASON SCOTT REAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5201
(740) 446-5761
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5201
(740) 446-5761
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35.092216
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2927604
OH MEDICAID MOLINA
OH
05
—
2927604
—
OH
01
—
308172
OH MEDICAID UNISON
OH
01
—
310917085154
OH MEDICAID CARESOURCE
OH
05
—
3810014270
—
WV
Enumeration date
04/20/2007
Last updated
04/10/2015
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