Organization
REYNOLDS PLASTIC SURGERY LLC
Active
Organization
REYNOLDS PLASTIC SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM R REYNOLDS M.D. (PHYSICIAN)
(417) 823-9777
Entity
Organization
Contact information
Practice address
1531 E BRADFORD PKWY, SUITE 215, SPRINGFIELD, MO 65804-6566
(417) 823-9777
(417) 823-9731
Mailing address
1531 E BRADFORD PKWY, SUITE 215, SPRINGFIELD, MO 65804-6566
(417) 823-9777
(417) 823-9731
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
107745
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201291408
—
MO
Enumeration date
06/20/2008
Last updated
11/22/2019
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