Individual
DR. RICHARD ALBERT KEITH REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5153 N 9TH AVE, PENSACOLA, FL 32504-8785
(850) 505-4720
(850) 505-4726
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
4301088730
MI
207X00000X
Orthopaedic Surgery Physician
A50293
CA
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
ME123787
FL
207XS0117X
Orthopaedic Surgery of the Spine Physician
A50293
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
'014781200
—
FL
01
—
20-0-82-6207-1
BCBSM
MI
05
—
4919117
—
MI
Enumeration date
06/22/2006
Last updated
03/28/2017
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