Individual provider · Type 1 NPI
Alexander Lawrence Reynolds, DO
Military Health Care Provider · Boise, ID
NPI number
1124317417
Active
Practice location
4492 S De Havilland St Bldg 469
Boise, ID 83705
Fax (208) 422-5388
Mailing address
4492 S De Havilland St, Building 469
Boise, ID 83705
Other practice locations
- 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 · (208) 828-7600
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine Physician | 207Q00000X | O-1760 (ID) |
| Military Health Care Provider Primary | 171000000X | O-1760 (ID) |
Military Health Care Provider: Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
About NPI 1124317417
Alexander Lawrence Reynolds, DO's National Provider Identifier is 1124317417, issued on Apr 7, 2011. The primary taxonomy on file is Military Health Care Provider (171000000X), and the practice location is in Boise, ID. The record was last updated on Oct 20, 2026.