Provider Demographics
NPI:1366432841
Name:REINHART, STEPHEN GERARD (OD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:GERARD
Last Name:REINHART
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7321 11TH ST
Mailing Address - Street 2:75TH MEDICAL GROUP
Mailing Address - City:HILL AFB
Mailing Address - State:UT
Mailing Address - Zip Code:84056-5012
Mailing Address - Country:US
Mailing Address - Phone:801-777-7506
Mailing Address - Fax:801-777-7516
Practice Address - Street 1:7321 11TH ST
Practice Address - Street 2:75TH MEDICAL GROUP
Practice Address - City:HILL AFB
Practice Address - State:UT
Practice Address - Zip Code:84056-5012
Practice Address - Country:US
Practice Address - Phone:801-777-7506
Practice Address - Fax:801-777-7516
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2106152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist