Individual
TERESA A REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3311 E MURDOCK ST, WICHITA, KS 67208-3054
(316) 689-9188
(316) 689-9140
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9102
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
22267
KS
207RR0500X
Rheumatology Physician
Primary
04-22267
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018255
BCBS
KS
05
—
100208490A
—
KS
01
—
12149395
MULTIPLAN
KS
01
—
16918
COVENTRY
KS
01
—
200145
HPK
KS
01
—
775
PHS
KS
Enumeration date
06/18/2006
Last updated
06/24/2015
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