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Individual

GEORGE M REYNOLDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1040 RIVER OAKS DR, SUITE 100, FLOWOOD, MS 39232-9530
(601) 936-5311
(601) 936-5313
Mailing address
1040 RIVER OAKS DR, SUITE 100, FLOWOOD, MS 39232-9530
(601) 936-5311
(601) 936-5313

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
10138
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00012187
MS
01
753068151
MHP
01
753068151016
TRICARE
Enumeration date
07/19/2006
Last updated
12/13/2012
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