Reeck, Matthew C

Reeck, Matthew C is an individual health care provider with primary practice located at 191 W 5Th St , Ketchum ID 83340-0000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Reeck, Matthew C can be contacted via phone (208) 725-2171.

Contact Information

Primary practice address
191 W 5Th St Ketchum ID 83340-0000
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 01054306A Indiana
Allopathic & Osteopathic Physicians / Dermatology 207N00000X M11887 Idaho

Profile Details

NPI number 1124022801
LBN Legal business name Reeck, Matthew C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Feb 5th, 2014 - about 12 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 1124022801 NPPES
Indiana MEDICAID 200310490

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