Individual
KEITH E MCREYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1460 E COLT ROAD, TEMPE, AZ 85284
(480) 227-0500
Mailing address
1460 E COLT ROAD, TEMPE, AZ 85284
(480) 227-0500
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
9169
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
STATE LICENSE # 9169
AZ MEDICAL BOARD
AZ
Enumeration date
05/17/2006
Last updated
07/23/2007
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