Provider Demographics
NPI:1134162571
Name:REED, HAROLD R III (MD)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:R
Last Name:REED
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 W MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-1935
Mailing Address - Country:US
Mailing Address - Phone:251-943-5437
Mailing Address - Fax:251-943-3227
Practice Address - Street 1:106 W MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-1935
Practice Address - Country:US
Practice Address - Phone:251-943-5437
Practice Address - Fax:251-943-3227
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10500208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000013444Medicaid
AL051075909OtherBLUE CROSS
AL051075909OtherBLUE CROSS