Individual
DR. SUSAN KIM REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
401 HOLLY HILLS AVE, SAINT LOUIS, MO 63111-2410
(314) 353-5190
(314) 353-7631
Mailing address
401 HOLLY HILLS AVE, SAINT LOUIS, MO 63111-2410
(314) 353-5190
(314) 353-7631
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036-126550
IL
207P00000X
Emergency Medicine Physician
R5E07
MO
207Q00000X
Family Medicine Physician
Primary
036126550
IL
207Q00000X
Family Medicine Physician
R5E07
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700877032
—
MO
Enumeration date
11/04/2005
Last updated
03/19/2025
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