MEDICARE: REYNOLDS PLASTIC SURGERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	14181	NV

General Provider Information

NPI Number	:	1003188145
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REYNOLDS PLASTIC SURGERY

Provider Business Mailing Address
First Line	:	7175 N DURANGO DR STE 230
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4484
Country	:	US
Telephone Number	:	702-410-9800
Fax Number	:

Provider Business Practice Location Address
First Line	:	7175 N DURANGO DR STE 230
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4484
Country	:	US
Telephone Number	:	702-410-9800
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRANDON QUAYLE REYNOLDS
Credential	:	M.D.
Telephone Number	:	717-557-6750

Provider Enumeration Date	:	02/06/2012
Last Update Date	:	04/09/2026

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