Individual
ALAN REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
425 PINE RIDGE BLVD, SUITE 211, WAUSAU, WI 54401-4123
(715) 845-5505
(715) 848-2884
Mailing address
425 PINE RIDGE BLVD, SUITE 211, WAUSAU, WI 54401-4123
(715) 845-5505
(715) 848-2884
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
20885020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16086
SECURITY HEALTH PLAN
WI
01
—
30272300
MANAGED HEALTH CARE
WI
05
—
30272300
—
WI
01
—
REYNOLDS
WPS
WI
Enumeration date
07/16/2006
Last updated
07/09/2007
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