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DR. KENNETH HOWARD REYNOLDS MD

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1205001658

Individual Registrant:
DR. KENNETH HOWARD REYNOLDS MD
Gender: M
Sole Proprietor

Location and contact information for practice:
24 WHETSTONE DR  MOUNT CRESTED BUTTE, CO 81225 US
Tel: 970-349-7341  Fax: --

Contact information for business:
PO BOX 2239  CRESTED BUTTE, CO 81224 US
Tel: 970-349-7341  Fax: --

Registration Information:
NPI: 1205001658
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
CO14826
N207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
GA09598
N207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
IDM7415

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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