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General NPI Number Information
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NPI Number | 1417923707
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Entity Type | Individual
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Provider Name | JOSE ISMAEL REYES MD
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Gender | Male
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 11125 JONES BRIDGE RD STE 100
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City | ALPHARETTA
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State | GA
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Zip | 30022-0001
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Country | US
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Telephone | 678-383-0008
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Fax | 470-735-6656
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Provider Business Mailing Address
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Address Line | 11125 JONES BRIDGE RD STE 100
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City | ALPHARETTA
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State | GA
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Zip | 30022-0001
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Country | US
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Telephone | 678-383-0008
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Fax | 470-735-6656
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 42593
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 102397
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License Number State | GA
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