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NPI Code Detail

MEDICARE: DR. JAMES B REYNOLDS

MEDICARE: DR. JAMES B REYNOLDS
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
1183500000XPharmacist12490SC

General Provider Information

NPI Number : 1538467436
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES B REYNOLDS
Provider Business Mailing Address
First Line : 52 JIB CT
Second Line :
City : GREENVILLE
State : SC
Zip : 29611-3063
Country : US
Telephone Number : 608-738-2524
Fax Number :
Provider Business Practice Location Address
First Line : 902 PELHAM RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29615-3639
Country : US
Telephone Number : 864-234-6462
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2011
Last Update Date : 03/02/2011

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