Reynolds, Mark Douglas

Reynolds, Mark Douglas is an individual health care provider with primary practice located at 5409 Avenue O Suite 118, Fort Madison IA 52627-9601. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Reynolds, Mark Douglas can be contacted via phone (319) 372-9292.

Contact Information

Primary practice address
5409 Avenue O Suite 118 Fort Madison IA 52627-9601
Phone: (319) 372-9292
Fax: (319) 372-3025
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 29979 Iowa

Profile Details

NPI number 1497793632
LBN Legal business name Reynolds, Mark Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Jul 20th, 2009 - about 17 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 1497793632 NPPES
Other IA0102 JOHN DEERE HEALTHCARE
MEDICAID 207737800 JOHN DEERE HEALTHCARE
MEDICAID 1113118 JOHN DEERE HEALTHCARE
Other 22227 JOHN DEERE HEALTHCARE

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