Provider Demographics
NPI:1578328027
Name:REYNOLDS, SYLVESTER R
Entity Type:Individual
Prefix:MR
First Name:SYLVESTER
Middle Name:R
Last Name:REYNOLDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3382 GA HIGHWAY 242
Mailing Address - Street 2:
Mailing Address - City:SANDERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31082-8113
Mailing Address - Country:US
Mailing Address - Phone:478-232-5582
Mailing Address - Fax:
Practice Address - Street 1:3382 GA HIGHWAY 242
Practice Address - Street 2:
Practice Address - City:SANDERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:31082-8113
Practice Address - Country:US
Practice Address - Phone:478-232-5582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)