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Individual
DR. TOMMY R REYNOLDS
Active
Individual
DR. TOMMY R REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
3519
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002025
SD BCBS
SD
05
—
0982801
—
IA
01
—
165034
UCARE
—
01
—
18-00050
MEDICA SELECTCARE
—
01
—
1M361RE
MN BCBS - PLAN 91057NO
MN
01
—
24691
HEALTH PARTNERS
—
01
—
3519
DAKOTACARE
SD
01
—
496L4RE
MN BC BS
MN
05
—
7300540
—
SD
01
—
931451029046
PREFERRED ONE
—
Enumeration date
06/05/2006
Last updated
03/31/2008
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