Reid, Walter Scott

Reid, Walter Scott is an individual health care provider with primary practice located at 900 Main St Suite 530, Peoria IL 61602-1005. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Reid, Walter Scott can be contacted via phone (309) 672-5975.

Contact Information

Primary practice address
900 Main St Suite 530 Peoria IL 61602-1005
Fax: (309) 655-1678
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 036095933 Illinois
Allopathic & Osteopathic Physicians / Surgery 208600000X 036095933 Illinois

Profile Details

NPI number 1932180387
LBN Legal business name Reid, Walter Scott
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2005
Last updated Aug 14th, 2020 - about 4 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 1932180387 NPPES
Illinois MEDICAID 036095933

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