Provider Demographics
NPI:1740222769
Name:REINER, RICHARD K (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:K
Last Name:REINER
Suffix:
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 1:1315 TIBBALS ST
Mailing Address - Street 2:
Mailing Address - City:HOLDREGE
Mailing Address - State:NE
Mailing Address - Zip Code:68949-1257
Mailing Address - Country:US
Mailing Address - Phone:308-995-6111
Mailing Address - Fax:308-995-4868
Practice Address - Street 1:1315 TIBBALS ST
Practice Address - Street 2:
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949-1257
Practice Address - Country:US
Practice Address - Phone:308-995-6111
Practice Address - Fax:308-995-4868
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15455207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEB67847Medicare UPIN