Healthcare Provider Details

I. General information

NPI: 1518306836
Provider Name (Legal Business Name): EVAN REINHARDT D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5227 N 7TH ST STE 83272
PHOENIX AZ
85014-2802
US

IV. Provider business mailing address

5227 N 7TH ST STE 83272
PHOENIX AZ
85014-2802
US

V. Phone/Fax

Practice location:
  • Phone: 808-344-3312
  • Fax: 833-412-1703
Mailing address:
  • Phone: 808-344-3312
  • Fax: 833-412-1703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10383926-1204
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: