Basic Information
| Provider Information | |||||||||
| NPI: | 1861768855 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PAUL Q. REYNOLDS, M.D., PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7220 S CIMARRON RD | ||||||||
| Address2: | STE 230 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891132159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028534240 | ||||||||
| FaxNumber: | 7028181928 | ||||||||
| Practice Location | |||||||||
| Address1: | 7220 S CIMARRON RD | ||||||||
| Address2: | STE 230 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891132159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028534240 | ||||||||
| FaxNumber: | 7028181928 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2012 | ||||||||
| LastUpdateDate: | 06/17/2013 | ||||||||
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| AuthorizedOfficialLastName: | REYNOLDS | ||||||||
| AuthorizedOfficialFirstName: | PAUL | ||||||||
| AuthorizedOfficialMiddleName: | QUAYLE | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7029173497 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 14255 | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.