Basic Information
| Provider Information | |||||||||
| NPI: | 1407961121 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCREYNOLDS | ||||||||
| FirstName: | JAMIE | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 220 GREENE PLZ | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | WAYNESBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153708144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7248526391 | ||||||||
| FaxNumber: | 7248526404 | ||||||||
| Practice Location | |||||||||
| Address1: | 220 GREENE PLZ | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | WAYNESBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153708144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7248526391 | ||||||||
| FaxNumber: | 7248526404 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2006 | ||||||||
| LastUpdateDate: | 08/08/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 15120 | AZ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.