Jordan Robert Reynolds, is a
Clinic/center - Mental Health (including Community Mental Health Center) based in Ada, Oklahoma. Jordan Robert Reynolds is licensed to practice in * (Not Available) (license number ) and his current practice location is
1300 Hoppe Blvd Ste 6, Ada, Oklahoma. He can be reached at his office (for appointments etc.) via phone at
(580) 399-7653.
NPI number for Jordan Robert Reynolds is 1568740405 and his current mailing address is 512 E 24th St, Tishomingo, Oklahoma. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1568740405.
Healthcare Provider's Profile
| Full Name | Jordan Robert Reynolds |
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| Gender | Male |
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| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
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| Location | 1300 Hoppe Blvd Ste 6, Ada, Oklahoma |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1568740405
- Provider Enumeration Date: 07/26/2011
- Last Update Date: 08/25/2024
Medical Identifiers
Medical identifiers for Jordan Robert Reynolds such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568740405 | NPI | - | NPPES |
| 1548339435 | Medicaid | OK | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jordan Robert Reynolds is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jordan Robert Reynolds,
512 E 24th St,
Tishomingo, OK 73460-3214
Ph: (580) 399-7653 | Jordan Robert Reynolds,
1300 Hoppe Blvd Ste 6,
Ada, OK 74820-2319
Ph: (580) 399-7653 |
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