Reynolds, Nathan Taylor
Reynolds, Nathan Taylor is an individual health care provider with primary practice located at 1301 Russell Rd , Russellville AR 72802-4320. He recently has only one registered license in Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, which is considered as his primary health care specialty. Reynolds, Nathan Taylor can be contacted via phone (479) 967-2322.Contact Information
Primary practice address
1301 Russell Rd
Russellville AR 72802-4320
Phone: (479) 967-2322
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics | 2080P0006X | 934496277 | Arkansas |
Profile Details
| NPI number | 1306594569 |
|---|---|
| LBN Legal business name | Reynolds, Nathan Taylor |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 16th, 2022 |
| Last updated | Jan 10th, 2023 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306594569 | NPPES |
| Arkansas | MEDICAID | 275004706 |
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