Provider Demographics
NPI:1518000447
Name:DAVID M REYNOLDS OD PC
Entity Type:Organization
Organization Name:DAVID M REYNOLDS OD PC
Other - Org Name:PRECISION EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MORGAN
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:704-788-3333
Mailing Address - Street 1:789 CONCORD PKWY N
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-6035
Mailing Address - Country:US
Mailing Address - Phone:704-788-3333
Mailing Address - Fax:704-788-3337
Practice Address - Street 1:789 CONCORD PKWY N
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-6035
Practice Address - Country:US
Practice Address - Phone:704-788-3333
Practice Address - Fax:704-788-3337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1554152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
26522OtherSPECTERA
118179OtherEYEMED
NC093G3OtherBLUE CROSS BLUE SHIELD NC
44039OtherDAVIS
NC89093G3Medicaid