Individual
DR. DEMETRA DIANE BARR REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1895 N JASPER DR STE 3, FLAGSTAFF, AZ 86001-1632
(928) 913-8800
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28556
AZ
207Q00000X
Family Medicine Physician
A63274
CA
207Q00000X
Family Medicine Physician
ME154526
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113774000
—
FL
Enumeration date
06/20/2006
Last updated
02/06/2025
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