Provider Demographics
NPI:1053381194
Name:REID, THOMAS MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MICHAEL
Last Name:REID
Suffix:
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 1:8960 CHESHIRE DR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84093-1851
Mailing Address - Country:US
Mailing Address - Phone:801-733-5988
Mailing Address - Fax:
Practice Address - Street 1:100 S 1000 W
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-4010
Practice Address - Country:US
Practice Address - Phone:435-843-3520
Practice Address - Fax:435-843-3555
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9326312712052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT260046045OtherRAILROAD MEDICARE
UTF70042OtherMEDICARE ADVANTAGE PLANS
UTS06740OtherMEDICARE ADVANTAGE PLANS
UT107007686101OtherINTRMTN. HEALTH CARE
UT261788OtherDESERET MUTUAL
UT942938348002OtherCHAMPUS
UT2084P0800XOtherTAXONOMY #
UT942938348REIOtherEDUCATORS MUTUAL
UT942938348REIOtherEDUCATORS MUTUAL
UT942938348002OtherCHAMPUS
UT002200211Medicare PIN
UT003104010Medicare PIN
UTS06740OtherMEDICARE ADVANTAGE PLANS
UT942938348REIOtherEDUCATORS MUTUAL
UT002200106Medicare PIN