DR. JACKSON DAVID REYNOLDS MD NPI 1598345647

NPI Information

NPI: 1598345647
Provider Name: DR. JACKSON DAVID REYNOLDS, MD
Classification: General Practice - 208D00000X
Entity Type: Individual
PECOS Registration: Yes
Address: 1300 N 12TH ST STE 508
PHOENIX, AZ
ZIP 85006
Phone: (602) 839-3927

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NPI Details

DR. Jackson David Reynolds, MD is a general practice in Phoenix, AZ. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DR. Jackson David Reynolds, MD NPI is 1598345647. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1300 N 12TH ST STE 508
PHOENIX, AZ
ZIP 85006-849
Phone: (602) 839-3927
Fax: (602) 839-4233

The NPI 1598345647 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/13/2021 and was last updated on 3/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	207R00000X	Internal Medicine	72531	ARIZONA	No
2	208000000X	Pediatrics	72531	ARIZONA	No
3	390200000X	Student in an Organized Health Care Education/Training Program			No
4	208D00000X	General Practice	72531	ARIZONA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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