Edward R Reynolds Jr. (NPI# 1013942549, PAC ID# 3072511617) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1013942549 |
| PAC ID by PECOS | 3072511617 |
| Professional Enrollment ID | I20061115000315 |
| Full Name | Edward R Reynolds Jr. |
| Organization Legal Name | PHILLIP L LATHAM JR |
| Address |
325 Broad St Suite 200 Sumter SC 29150-4167 |
| Phone Number | 8037754469 |
| Gender | M |
| Credential | PA |
| Medical School | MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE |
| Graduation Year | 2002 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4385642859 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420070 | TUOMEY HEALTHCARE SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 325 Broad St, Suite 200, Sumter, SC 29150-4167 | 8037754469 | PHILLIP L LATHAM JR |
| Organization Legal Name | PHILLIP L LATHAM JR |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sylvia L Parra | Dermatology | Phillip L Latham Jr | 325 Broad St, Suite 200, Sumter, SC 29150-4167 |
| Phillip Lane Latham Jr. | Dermatology | Phillip L Latham Jr | 325 Broad St, Suite 200, Sumter, SC 29150-4167 |
| Street Address |
325 BROAD ST SUITE 200 |
| City | SUMTER |
| State | SC |
| Zip | 29150-4167 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amber Ballentine | Nurse Practitioner | Colonial Family Practice LLC | 325 Broad St, Suite 100, Sumter, SC 29150-4167 |
| Mitchell R Grunsky | Family Medicine | Colonial Family Practice LLC | 325 Broad St, Suite 100, Sumter, SC 29150-4167 |
| Michael Chandler | Family Medicine | Colonial Family Practice LLC | 325 Broad St, Suite 100, Sumter, SC 29150-4167 |
| Sylvia L Parra | Dermatology | Phillip L Latham Jr | 325 Broad St, Suite 200, Sumter, SC 29150-4167 |
| Winston B Morris | Family Medicine | Colonial Family Practice LLC | 325 Broad St, Suite 100, Sumter, SC 29150-4167 |
| Lisa J Smith | Physician Assistant | Colonial Family Practice LLC | 325 Broad St, Suite 100, Sumter, SC 29150-4167 |
| Phillip Lane Latham Jr. | Dermatology | Phillip L Latham Jr | 325 Broad St, Suite 200, Sumter, SC 29150-4167 |
| Carrie Hoshour | Nurse Practitioner | Colonial Family Practice LLC | 325 Broad St, Suite 100, Sumter, SC 29150-4167 |
| Kaoru Joan Pridgen | Family Medicine | Colonial Family Practice LLC | 325 Broad St, Suite 100, Sumter, SC 29150-4167 |
| Mary Kathleen Cox | Nurse Practitioner | Colonial Family Practice LLC | 325 Broad St, Suite 100, Sumter, SC 29150-4167 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Niaya Mccleave | Occupational Therapy | Functional Pathways Preferred of Tennessee LLC | 2825 Carter Rd, Sumter, SC 29150-1712 |
| Stacey Kelso | Occupational Therapy | Functional Pathways Preferred of Tennessee LLC | 2825 Carter Rd, Sumter, SC 29150-1712 |
| Karly M Yarnish | Occupational Therapy | Functional Pathways Preferred of Tennessee LLC | 2825 Carter Rd, Sumter, SC 29150-1712 |
| Myra Cooke | Qualified Speech Language Pathologist | Functional Pathways Preferred of Tennessee LLC | 2825 Carter Rd, Sumter, SC 29150-1712 |
| Sharon T Johnson | Nurse Practitioner | Agape Senior Primary Care Inc | 1180 Wilson Hall Rd, Sumter, SC 29150-1738 |
| Harry A Jordan Jr. | Internal Medicine | Mcleod Physician Associates II | 1295 Wilson Hall Rd, Sumter, SC 29150-1804 |
| James R Mcmahon | Nurse Practitioner | Mcleod Physician Associates II | 1295 Wilson Hall Rd, Sumter, SC 29150-1804 |
| Ansel Rose Mcfaddin Iii | Internal Medicine | Mcleod Physician Associates II | 1295 Wilson Hall Rd, Sumter, SC 29150-1804 |
| Katherine A Coffey | Physician Assistant | Mcleod Physician Associates II | 1295 Wilson Hall Rd, Sumter, SC 29150-1804 |
| Emily J Miller | Physician Assistant | Mcleod Physician Associates II | 1295 Wilson Hall Rd, Sumter, SC 29150-1804 |
| Find all physicians in zip 29150 | |||
| City | SUMTER |
| Zip Code | 29150 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | SUMTER + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Edward R Reynolds Jr..
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.