Individual
BRADFORD Z. REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-4951
(706) 721-7941
Mailing address
1499 WALTON WAY, STE 1400, AUGUSTA, GA 30901-2602
(706) 828-6410
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
053143
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161437336A
—
GA
05
—
G53143
—
SC
Enumeration date
08/30/2006
Last updated
03/31/2011
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