Reaves, Ricky

Reaves, Ricky is an individual health care provider with primary practice located at 3509 French Park Dr Ste D, Edmond OK 73034-7296. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology, which is considered as his primary health care specialty. Reaves, Ricky can be contacted via phone (405) 715-4500.

Contact Information

Primary practice address
3509 French Park Dr Ste D Edmond OK 73034-7296
Phone: (405) 715-4500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology 207ZP0101X 16463 Oklahoma

Profile Details

NPI number 1518987817
LBN Legal business name Reaves, Ricky
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518987817 NPPES
Other 731527740 TAX ID/GROUP MEDICARE
MEDICAID 100746640A TAX ID/GROUP MEDICARE

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