Individual
TERRY L REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2415 PARKWOOD DRIVE, BRUNSWICK, GA 31520-4722
(912) 466-1217
(912) 466-1213
Mailing address
P.O. BOX 1213, BRUNSWICK, GA 31521-1213
(912) 466-1217
(912) 466-1213
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
021793
GA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
021793
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000233725D
—
GA
Enumeration date
10/23/2005
Last updated
05/06/2019
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