Individual
DR. WADE D REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
111 IVY PARK LANE, SUITE C, LEXINGTON, SC 29072
(864) 885-7935
Mailing address
111 IVY PARK LANE, SUITE C, LEXINGTON, SC 29072
(803) 785-4555
(803) 785-4556
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
417
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T00273
—
SC
Enumeration date
08/11/2006
Last updated
12/20/2012
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