Individual
DR. LAWRENCE LEWIS REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
252 SELDOVIA ST, SELDOVIA, AK 99663-0210
(907) 234-7825
(907) 234-7825
Mailing address
DRAWER J, 252 SELDOVIA ST, SELDOVIA, AK 99663-0210
(907) 234-7825
(907) 234-7825
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
1164
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0200641039
CLIA
—
05
—
MD1164
—
AK
Enumeration date
11/16/2006
Last updated
07/08/2007
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