Individual
JON WELLINGTON REYNOLDS
Active
Individual
JON WELLINGTON REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2003-01404
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
200301404
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1425R
BCBS
—
01
—
190682
MEDCOST
—
05
—
3810008337
—
WV
05
—
5904515
—
NC
01
—
7897877
AETNA
—
01
—
808416
PARTNERS
—
01
—
P00397986
RR MEDICARE
—
05
—
Q0140H
—
SC
Enumeration date
07/03/2006
Last updated
09/08/2017
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