Provider Demographics
NPI:1902148166
Name:REEVES, ALLEN ROBERT
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:ROBERT
Last Name:REEVES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 FRANTZ RD STE 360
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4141
Mailing Address - Country:US
Mailing Address - Phone:740-420-8521
Mailing Address - Fax:740-420-8526
Practice Address - Street 1:600 N PICKAWAY ST
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1447
Practice Address - Country:US
Practice Address - Phone:740-420-8521
Practice Address - Fax:740-420-8526
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.128060207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3600271OtherAKRON GENERAL MEDICAL CENTER - IMCA GROUP MEDICARE #
OH0169285Medicaid
OH0454744OtherAKRON GENERAL MEDICAL CENTER - IMCA GROUP MEDICAID #
OH1821035940OtherAKRON GENERAL MEDICAL CENTER - IMCA TYPE 2 NPI #
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #