Healthcare Provider Details

I. General information

NPI: 1124002456
Provider Name (Legal Business Name): DOUGLAS M REZNICK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S POTOMAC ST
AURORA CO
80012-5405
US

IV. Provider business mailing address

7951 E MAPLEWOOD AVE STE 350
GREENWOOD VILLAGE CO
80111-4758
US

V. Phone/Fax

Practice location:
  • Phone: 303-418-7600
  • Fax: 303-750-3137
Mailing address:
  • Phone: 303-930-7895
  • Fax: 832-601-6018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberDR.0034032
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: