Reach, Brian Jay

Reach, Brian Jay is an individual health care provider with primary practice located at 300 W Oak St , Carbondale IL 62901-1400. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Reach, Brian Jay can be contacted via phone (217) 545-8000.

Contact Information

Primary practice address
300 W Oak St Carbondale IL 62901-1400
Phone: (217) 545-8000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-099587 Illinois

Profile Details

NPI number 1104824598
LBN Legal business name Reach, Brian Jay
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2005
Last updated Nov 10th, 2021 - about 3 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 1104824598 NPPES
Illinois MEDICAID 036-099587
Illinois Other H04942
Illinois Other H04942
Illinois Other 411176
Illinois Other H04942
Illinois Other K01261
Illinois Other 036099587
Illinois Other 052910
Illinois Other H04942

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