Reavis, Wilton Mclean

Reavis, Wilton Mclean is an individual health care provider with primary practice located at 1125 Us Highway 98 S Suite 101, Lakeland FL 33801-5852. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Reavis, Wilton Mclean can be contacted via phone (863) 683-7171.

Contact Information

Primary practice address
1125 Us Highway 98 S Suite 101 Lakeland FL 33801-5852
Phone: (863) 683-7171
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X ME0031892 Florida

Profile Details

NPI number 1790753465
LBN Legal business name Reavis, Wilton Mclean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2006
Last updated Apr 22nd, 2008 - about 16 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 1790753465 NPPES
Florida MEDICAID 44252600

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