Healthcare Provider Details

I. General information

NPI: 1952246571
Provider Name (Legal Business Name): KRISTEN M REYNOLDS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST
AUGUSTA GA
30912-0006
US

IV. Provider business mailing address

3601 MOSSWOOD RD
MONTGOMERY AL
36116-5618
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-7005
  • Fax: 706-446-3546
Mailing address:
  • Phone: 334-399-8212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: