Individual
DR. MARK PAUL REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2195 E CUSTER AVE, HELENA, MT 59602-1217
(406) 495-7053
(406) 495-7052
Mailing address
PO BOX 1277, EAST HELENA, MT 59635-1277
(406) 495-7052
(406) 495-7052
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
425OPT
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0483912
—
MT
01
—
28260
BCBS
MT
01
—
410044874
RAILROAD MEDICARE
MT
Enumeration date
10/12/2005
Last updated
08/29/2012
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