Individual
JACOB REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 MARTIN LUTHER KING DR, MANKATO, MN 56001-6460
(507) 385-6500
(507) 385-6510
Mailing address
101 MARTIN LUTHER KING DR, MANKATO, MN 56001-6460
(507) 385-6500
(507) 385-6510
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
62613
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2016
Last updated
01/23/2018
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