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Organization

MCREYNOLDS MEDICAL ENTERPRISES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT MCREYNOLDS MD (OWNER/PHYSICIAN)
(765) 729-1274
Entity
Organization

Contact information

Practice address
868 ULULANI ST STE 108, HILO, HI 96720-3913
(765) 729-1274
Mailing address
868 ULULANI ST STE 108, HILO, HI 96720-3913
(765) 729-1274

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001266
HI
01
1659767275
TRICARE PPO
HI
01
R057879
UHA
HI
01
SMXPR0059333
ALOHACARE
HI
Enumeration date
07/31/2024
Last updated
07/31/2024
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