Provider Demographics
NPI:1124002456
Name:REZNICK, DOUGLAS M (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:M
Last Name:REZNICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7951 E MAPLEWOOD AVE STE 350
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4758
Mailing Address - Country:US
Mailing Address - Phone:303-930-7895
Mailing Address - Fax:303-267-4477
Practice Address - Street 1:1700 S POTOMAC ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5405
Practice Address - Country:US
Practice Address - Phone:303-418-7600
Practice Address - Fax:303-750-3137
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2023-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO34032207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO96022531Medicaid
CO96022531Medicaid
H53508Medicare UPIN