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General NPI Number Information
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NPI Number | 1598832792
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Entity Type | Individual
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Provider Name | KAREN REYNOLDS M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 5398 THOMASTON RD
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City | MACON
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State | GA
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Zip | 31220-8110
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Country | US
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Telephone | 478-743-8316
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Fax | 787-431-8244
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Provider Business Mailing Address
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Address Line | PO BOX 366
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City | MC BEE
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State | SC
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Zip | 29101-0366
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Country | US
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Telephone | 843-335-8291
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Fax | 843-335-8731
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 91570
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License Number State | GA
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