Individual
DR. THOMAS M REYNOLDS
Active
Individual
DR. THOMAS M REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD016274
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1187690001
DMERC GROUP SUPPLIER NUMB
SC
01
—
180029644
RR MEDICARE
—
05
—
3031931
—
TN
01
—
3069497
BLUE CROSS
—
05
—
3711088
—
TN
01
—
62-1701871
TAX ID
—
Enumeration date
07/18/2005
Last updated
06/19/2008
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