Reynolds, Leah R

Reynolds, Leah R is an individual health care provider with primary practice located at 4245 Johns Creek Pkwy Ste D, Suwanee GA 30024-9121. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Reynolds, Leah R can be contacted via phone (770) 495-3820.

Contact Information

Primary practice address
4245 Johns Creek Pkwy Ste D Suwanee GA 30024-9121
Phone: (770) 495-3820
Fax: (770) 495-3825
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 3344 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 6370 Georgia

Profile Details

NPI number 1124088851
LBN Legal business name Reynolds, Leah R
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2006
Last updated Feb 1st, 2017 - about 8 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 1124088851 NPPES
Georgia MEDICAID 003121895D
Georgia MEDICAID 003121895F
Georgia Other P00380758
Georgia MEDICAID 069627

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