Reynolds, Kent Douglas
Reynolds, Kent Douglas is an individual health care provider with primary practice located at 2700 14Th Ave Se , Albany OR 97322-6956. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Reynolds, Kent Douglas can be contacted via phone (541) 928-1667.Contact Information
Primary practice address
2700 14Th Ave Se
Albany OR 97322-6956
Phone: (541) 928-1667
Fax: (541) 928-1817
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | TA1285 | Maryland |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3022ATI | Oregon |
Profile Details
| NPI number | 1043226178 |
|---|---|
| LBN Legal business name | Reynolds, Kent Douglas |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 31st, 2006 |
| Last updated | Nov 5th, 2008 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043226178 | NPPES |
| Oregon | MEDICAID | 025040 | |
| Oregon | MEDICAID | 983001400 |
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