MEDICARE: REYNOLDS & ANLIKER EYE PHYSICIANS & SURGEONS, PA

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	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1144435207
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REYNOLDS & ANLIKER EYE PHYSICIANS & SURGEONS, PA

Provider Business Mailing Address
First Line	:	1602 W 15TH AVE
Second Line	:	STE B
City	:	EMPORIA
State	:	KS
Zip	:	66801-5672
Country	:	US
Telephone Number	:	620-342-6989
Fax Number	:	620-342-2262

Provider Business Practice Location Address
First Line	:	1602 W 15TH AVE
Second Line	:	STE B
City	:	EMPORIA
State	:	KS
Zip	:	66801-5672
Country	:	US
Telephone Number	:	620-342-6989
Fax Number	:	620-342-2262

Authorized Official
Title or Position	:	OWNER OPHTHALMOLOGIST
Name	:	MICHAEL G REYNOLDS
Credential	:	MD
Telephone Number	:	620-342-6989

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	04/12/2013

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