Provider Demographics
NPI:1144243114
Name:JULES REINHARDT D O PC
Entity Type:Organization
Organization Name:JULES REINHARDT D O PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULES
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:REINHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:810-245-3629
Mailing Address - Street 1:1457 SUNCREST DR
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-1151
Mailing Address - Country:US
Mailing Address - Phone:810-245-3629
Mailing Address - Fax:810-245-3640
Practice Address - Street 1:1457 SUNCREST DR
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-1151
Practice Address - Country:US
Practice Address - Phone:810-245-3629
Practice Address - Fax:810-245-3640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101004966207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N99370Medicare PIN