MEDICARE: BRANDON REYNOLDS M.D.

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	:	1962616383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON REYNOLDS M.D.

Provider Business Mailing Address
First Line	:	5550 PAINTED MIRAGE RD
Second Line	:	STE 217
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4620
Country	:	US
Telephone Number	:	702-410-9800
Fax Number	:	702-924-1520

Provider Business Practice Location Address
First Line	:	8285 W ARBY AVE
Second Line	:	STE. 380
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2235
Country	:	US
Telephone Number	:	702-410-9800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	08/02/2017

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Directions to “ BRANDON REYNOLDS M.D.” Practice Location

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