Reynolds, William Robert

Reynolds, William Robert is an individual health care provider with primary practice located at 1531 E Bradford Pkwy Ste 215 , Springfield MO 65804-6539. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Reynolds, William Robert can be contacted via phone (417) 894-1079.

Contact Information

Primary practice address
1531 E Bradford Pkwy Ste 215 Springfield MO 65804-6539
Phone: (417) 894-1079
Fax: (417) 823-9731
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 107745 Missouri

Profile Details

NPI number 1154416006
LBN Legal business name Reynolds, William Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Nov 22nd, 2019 - about 7 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 1154416006 NPPES
Missouri MEDICAID 1154416006
Missouri MEDICAID 1336300466

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