Individual
WILLIAM T REYNOLDS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1020 GIBSON BAY DR, RICHMOND, KY 40475-3448
(859) 623-3358
(859) 623-8141
Mailing address
1020 GIBSON BAY DR, RICHMOND, KY 40475-3448
(859) 623-3358
(859) 623-8141
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1069 DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000051583
ANTHEM
KY
01
—
1069 DT
OPTOMETRIC LICENSE
KY
01
—
1312022
CIGNA
KY
01
—
410040399
RAILROAD
KY
01
—
4357622
AETNA
KY
05
—
77010692
—
KY
Enumeration date
08/24/2005
Last updated
03/07/2023
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