Provider Demographics
NPI:1114978616
Name:REYNOLDS, JAMES A (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:REYNOLDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:600 ST CLAIR
Mailing Address - Street 2:BLDG 7 STE 17
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801
Mailing Address - Country:US
Mailing Address - Phone:256-534-1276
Mailing Address - Fax:256-519-2972
Practice Address - Street 1:600 ST CLAIR
Practice Address - Street 2:BLDG 7 STE 17
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-534-1276
Practice Address - Fax:256-519-2972
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2008-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL00013887208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C76496Medicare UPIN