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Contact Information

MARK D REYNOLDS, MD
5409 AVENUE O
SUITE 118
FORT MADISON, IA52627-9601
 Phone: 319-372-9292
 Fax: 319-372-3025
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for MARK D REYNOLDS · (Male)

NPI # 1497793632
Status Active
Credentials MD
Entity Individual
Enumeration date 06/02/2006
Last updated 07/20/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • IA License # 29979
  • IA Medicaid 1113118
  • MO Medicaid 207737800
  • Other 22227 IOWA HEALTH SOLUTIONS
  • Other IA0102 JOHN DEERE HEALTHCARE
Hospital affiliation(s)
  • GREAT RIVER MEDICAL CENTER - (Acute Care)
    1221 SOUTH GEAR AVENUE
    WEST BURLINGTON, IA 52655
  • KEOKUK AREA HOSPITAL - (Acute Care)
    1600 MORGAN STREET
    KEOKUK, IA 52632
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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