Provider Demographics
NPI:1417058868
Name:REINTJES, MARK G (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:G
Last Name:REINTJES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1900 W 47TH PL
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-1815
Mailing Address - Country:US
Mailing Address - Phone:913-261-6114
Mailing Address - Fax:913-261-6414
Practice Address - Street 1:1900 W 47TH PL
Practice Address - Street 2:SUITE 400
Practice Address - City:WESTWOOD
Practice Address - State:KS
Practice Address - Zip Code:66205-1815
Practice Address - Country:US
Practice Address - Phone:913-261-6114
Practice Address - Fax:913-261-6414
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2013-04-04
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Provider Licenses
StateLicense IDTaxonomies
MO1999140155208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205129406Medicaid
MO205129406Medicaid