Individual
DR. TOMMY R REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4520 W 69TH ST, SIOUX FALLS, SD 57108-8148
(605) 977-5000
(605) 977-5377
Mailing address
PO BOX 5009, SIOUX FALLS, SD 57117-5009
(605) 977-5000
(605) 977-5377
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
3519
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002025
SD BCBS
SD
05
—
0982801
—
IA
01
—
165034
UCARE
—
01
—
18-00050
MEDICA SELECTCARE
—
01
—
1M361RE
MN BCBS - PLAN 91057NO
MN
01
—
24691
HEALTH PARTNERS
—
01
—
3519
DAKOTACARE
SD
01
—
496L4RE
MN BC BS
MN
05
—
7300540
—
SD
01
—
931451029046
PREFERRED ONE
—
Enumeration date
06/05/2006
Last updated
03/31/2008
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