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NPI Code Detail

MEDICARE: DR. JONATHAN A REIMER DO

MEDICARE: DR. JONATHAN A REIMER DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician036153303IL
2208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician33255MS
3208600000XSurgery Physician125.070609IL

General Provider Information

NPI Number : 1720517873
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN A REIMER DO
Provider Business Mailing Address
First Line : 2500 N STATE ST
Second Line :
City : JACKSON
State : MS
Zip : 39216-4500
Country : US
Telephone Number : 617-997-3196
Fax Number :
Provider Business Practice Location Address
First Line : 2500 N STATE STREET
Second Line : OLD HOSPITAL 3 SOUTH, ROOM S376
City : JACKSON
State : MS
Zip : 39216-4500
Country : US
Telephone Number : 601-984-6603
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2017
Last Update Date : 06/22/2026

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