Individual
KAREN E REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
608 W BROWN ST, WAUPUN, WI 53963-1702
(920) 324-6853
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
(920) 926-8370
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
53827
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34532800
—
WI
01
—
P00893766
RAILROAD MEDICARE
WI
Enumeration date
12/14/2005
Last updated
12/16/2020
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