Provider Demographics
NPI:1699121707
Name:REYNOLDS, ABBY LAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:ABBY
Middle Name:LAYNE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:ABBY
Other - Middle Name:LAYNE
Other - Last Name:JESSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:920 STANTON L YOUNG BLVD # WP3440
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5036
Mailing Address - Country:US
Mailing Address - Phone:405-271-5251
Mailing Address - Fax:
Practice Address - Street 1:920 STANTON L YOUNG BLVD STE 3440
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5036
Practice Address - Country:US
Practice Address - Phone:405-271-5251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OK394152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program