Individual
SPENCER TIMOTHY REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 KINGS HIGHWAY, EMERGENCY MEDICINE/FAMILY MEDICINE, SHREVEPORT, LA 71130
(318) 626-0014
Mailing address
199 COUNTY ROAD 3329, ATLANTA, TX 75551-1522
(903) 733-3099
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
320024
LA
207Q00000X
Family Medicine Physician
320024
LA
Other
Enumeration date
04/02/2018
Last updated
07/29/2019
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