Reynolds, Wayne J

Reynolds, Wayne J is an individual health care provider with primary practice located at 5659 Parkway Dr Ste 210, Gloucester VA 23061-3792. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Reynolds, Wayne J can be contacted via phone (804) 210-1025.

Contact Information

Primary practice address
5659 Parkway Dr Ste 210 Gloucester VA 23061-3792
Fax: (804) 210-1029
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0102049941 Virginia

Profile Details

NPI number 1851366173
LBN Legal business name Reynolds, Wayne J
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Feb 1st, 2012 - about 14 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 1851366173 NPPES
Virginia MEDICAID 010118433
Virginia MEDICAID 005630789
Virginia MEDICAID 005829275

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