Provider Demographics
NPI:1669288619
Name:CHANEY, REYNAUD
Entity type:Individual
Prefix:
First Name:REYNAUD
Middle Name:
Last Name:CHANEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:REYZOR
Other - Middle Name:
Other - Last Name:SHARP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1301 HIGHPOINT TER
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-1622
Mailing Address - Country:US
Mailing Address - Phone:205-369-7213
Mailing Address - Fax:
Practice Address - Street 1:3985 PARKWOOD RD
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-5690
Practice Address - Country:US
Practice Address - Phone:205-369-7213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-05
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
No335E00000XSuppliersProsthetic/Orthotic Supplier