Provider Demographics
NPI:1356630735
Name:REINTJES, STEPHEN JR (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:REINTJES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 CLAY EDWARDS DR STE 410
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3258
Mailing Address - Country:US
Mailing Address - Phone:816-471-8114
Mailing Address - Fax:816-842-5342
Practice Address - Street 1:2750 CLAY EDWARDS DR STE 410
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116
Practice Address - Country:US
Practice Address - Phone:816-471-8114
Practice Address - Fax:816-842-5342
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MO2018008445207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program