Basic Information
Provider Information
NPI: 1073733093
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REYNOLDS
FirstName: DREW
MiddleName: HOWARD
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 356 24TH AVE N STE 300
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372031569
CountryCode: US
TelephoneNumber: 6152925722
FaxNumber: 6153466225
Practice Location
Address1: 4230 HARDING PIKE STE 525
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372052075
CountryCode: US
TelephoneNumber: 6153851547
FaxNumber: 6152979161
Other Information
ProviderEnumerationDate: 05/01/2007
LastUpdateDate: 09/13/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XMD48782TNY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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