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General NPI Number Information
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NPI Number | 1952560336
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Entity Type | Organization
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Legal Business Name | MCREYNOLDS ANESTHESIA, PA
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Dates
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Enumeration Date | 06/02/2008
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 640 LEIGH DR
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City | COLUMBUS
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State | MS
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Zip | 39705-3014
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Country | US
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Telephone | 662-328-7123
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Fax | 662-328-7156
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Provider Business Mailing Address
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Address Line | PO BOX 235022
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City | MONTGOMERY
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State | AL
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Zip | 36123-5022
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Country | US
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Telephone | 334-386-2053
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Fax | 334-244-1830
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN T MCREYNOLDS
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Credential | MD
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Telephone | 662-328-7123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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