Individual
DR. MARK DOUGLAS REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5409 AVENUE O, SUITE 118, FORT MADISON, IA 52627-9601
(319) 372-9292
(319) 372-3025
Mailing address
5409 AVENUE O, SUITE 118, FORT MADISON, IA 52627-9601
(319) 372-9292
(319) 372-3025
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
29979
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1113118
—
IA
05
—
207737800
—
MO
01
—
22227
IOWA HEALTH SOLUTIONS
—
01
—
IA0102
JOHN DEERE HEALTHCARE
—
Enumeration date
06/02/2006
Last updated
07/20/2009
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