Reynolds, Clyde Douglas

Reynolds, Clyde Douglas is an individual health care provider with primary practice located at 460 E Nine Mile Rd , Pensacola FL 32514-1441. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Reynolds, Clyde Douglas can be contacted via phone (850) 477-1499.

Contact Information

Primary practice address
460 E Nine Mile Rd Pensacola FL 32514-1441
Phone: (850) 477-1499
Fax: (850) 479-3359
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPC3828 Florida

Profile Details

NPI number 1811975634
LBN Legal business name Reynolds, Clyde Douglas
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2006
Last updated Jul 8th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811975634 NPPES
Florida Other 45012 BCBS PROVIDER NUMBER
Florida Other P00229829 BCBS PROVIDER NUMBER

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