Provider Demographics
NPI:1538120803
Name:REISFIELD, GARY MITCHEL (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:MITCHEL
Last Name:REISFIELD
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:DEPARTMENT OF PSYCHIATRY
Mailing Address - Street 2:BOX 100256
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0256
Mailing Address - Country:US
Mailing Address - Phone:352-265-7981
Mailing Address - Fax:352-265-7981
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:BOX 100256
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0256
Practice Address - Country:US
Practice Address - Phone:352-265-7981
Practice Address - Fax:352-265-7983
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME54511207L00000X, 207LP2900X, 2084P0800X, 207LA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00140464OtherRAILROAD MEDICARE
GA152680155AMedicaid
FL2704137-00Medicaid
FLE65205Medicare UPIN
FLP00140464OtherRAILROAD MEDICARE
GA152680155AMedicaid