Individual
DONALD JAMES REYNOLDS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1210 W FARIS RD, GREENVILLE, SC 29605-4444
(864) 522-1800
(864) 522-1806
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
81700
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009932442
—
AL
05
—
009932443
—
AL
05
—
009932444
—
AL
05
—
009932446
—
AL
05
—
009934022
—
AL
05
—
3300039
—
TN
01
—
4187363
TNCARE SELECT
TN
01
—
51001619
BC GREYSTONE
AL
01
—
51001624
BC MONTCLAIR
AL
01
—
51001627
BC SHELBY
AL
01
—
51001628
BC 280
AL
01
—
51001630
BC SYLACAUGA
AL
05
—
817004
—
SC
01
—
P00632720
RAILROAD MEDICARE
—
Enumeration date
11/15/2005
Last updated
05/06/2021
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