Provider Demographics
NPI:1811546625
Name:REINHART, GREG (PA-C)
Entity type:Individual
Prefix:
First Name:GREG
Middle Name:
Last Name:REINHART
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1260 S CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-0504
Mailing Address - Country:US
Mailing Address - Phone:520-407-5600
Mailing Address - Fax:520-407-5990
Practice Address - Street 1:1260 S CAMPBELL AVE BLDG 2
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-0502
Practice Address - Country:US
Practice Address - Phone:502-407-5400
Practice Address - Fax:520-407-5990
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ7494363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant