Provider Demographics
NPI:1053386466
Name:REED, DANIEL R (DO)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:R
Last Name:REED
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:300 W CLARENDON AVE STE 350
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3497
Mailing Address - Country:US
Mailing Address - Phone:602-274-4448
Mailing Address - Fax:602-287-9406
Practice Address - Street 1:5555 W THUNDERBIRD RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4622
Practice Address - Country:US
Practice Address - Phone:602-274-4484
Practice Address - Fax:602-287-9406
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ41852085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ916132OtherAHCCCS
AZI25968Medicare UPIN
AZ101642Medicare ID - Type Unspecified