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NPI Code Detail

MEDICARE: DR. TARA P REYNOLDS MD

MEDICARE: DR. TARA P REYNOLDS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianE4035AR
2207Q00000XFamily Medicine PhysicianME89097FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588634687
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TARA P REYNOLDS MD
Provider Business Mailing Address
First Line : 3201 SPRINGHILL DR STE 300
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72117-2909
Country : US
Telephone Number : 501-534-4300
Fax Number :
Provider Business Practice Location Address
First Line : 3201 SPRINGHILL DR STE 300
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72117-2909
Country : US
Telephone Number : 501-534-4300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2006
Last Update Date : 06/01/2024

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Directions to “ DR. TARA P REYNOLDS MD” Practice Location

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