Basic Information
| Provider Information | |||||||||
| NPI: | 1518941376 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCREYNOLDS | ||||||||
| FirstName: | JOEL | ||||||||
| MiddleName: | MATTHEW | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 INDEPENDENCE PT STE 212 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296154536 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 22725 HIGHWAY 76 E | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8648339100 | ||||||||
| FaxNumber: | 8648339458 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2005 | ||||||||
| LastUpdateDate: | 10/21/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 44301 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 36908 | SC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 10971 | NV | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 01080560A | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 36908 | SC | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 10971 | NV | N | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.