Reynolds, Daryl Gordon

Reynolds, Daryl Gordon is an individual health care provider with primary practice located at 566 S 8Th St , Griffin GA 30224-4212. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Reynolds, Daryl Gordon can be contacted via phone (770) 227-9432.

Contact Information

Primary practice address
566 S 8Th St Griffin GA 30224-4212
Phone: (770) 227-9432
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X RPH023082 Georgia

Profile Details

NPI number 1275605677
LBN Legal business name Reynolds, Daryl Gordon
Credentials PHARMD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2006
Last updated Jul 9th, 2007 - about 19 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 1275605677 NPPES
Georgia MEDICAID 00259806A

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