Individual
DOUGLAS SHIRLEY REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
904 ANNA AVE, TUSCALOOSA, AL 35401
(205) 345-6960
(205) 345-1147
Mailing address
904 ANNA AVE, TUSCALOOSA, AL 35401
(205) 345-6960
(205) 345-1147
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10975
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08350
BLUE CROSS BLUE SHIELD
AL
Enumeration date
09/13/2006
Last updated
11/02/2007
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