MEDICARE: DR. MARY REYNOLDS M.D.

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
1	207Q00000X	Family Medicine Physician	40190	CO

Other Identifiers

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

General Provider Information

NPI Number	:	1790782944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY REYNOLDS M.D.

Provider Business Mailing Address
First Line	:	1805 SHEA CENTER DR STE 450
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80129-2255
Country	:	US
Telephone Number	:	303-357-2559
Fax Number	:	720-573-6156

Provider Business Practice Location Address
First Line	:	9950 W 80TH AVE STE 23
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80005-3914
Country	:	US
Telephone Number	:	303-827-7844
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	12/24/2025

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Directions to “ DR. MARY REYNOLDS M.D.” Practice Location

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