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General NPI Number Information
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NPI Number | 1942707591
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Entity Type | Individual
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Provider Name | JESSICA REYES MD
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Gender | Female
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Dates
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Enumeration Date | 04/10/2018
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 16915 HIGHWAY 67 STE A
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City | STATESBORO
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State | GA
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Zip | 30458-5819
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Country | US
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Telephone | 912-644-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 460 MALL BLVD STE B
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City | SAVANNAH
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State | GA
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Zip | 31406-4891
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Country | US
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Telephone | 912-644-5300
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Fax |
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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 | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 101693
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 101693
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License Number State | GA
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