Individual
MR. NATHAN TAYLOR REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1301 RUSSELL RD, RUSSELLVILLE, AR 72802-4320
(479) 967-2322
Mailing address
PO DRAWER 2109, RUSSELLVILLE, AR 72811
(479) 967-2322
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
934496277
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275004706
—
AR
Enumeration date
03/16/2022
Last updated
01/10/2023
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