Healthcare Provider Details

I. General information

NPI: 1457341174
Provider Name (Legal Business Name): JAMES S REITMAN II MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4102 PINION DR INTERNAL MEDICINE CLINIC/SGOMI
U S A F ACADEMY CO
80840-2502
US

IV. Provider business mailing address

225 MEDFORD DR
COLORADO SPRINGS CO
80921-2559
US

V. Phone/Fax

Practice location:
  • Phone: 719-333-4554
  • Fax: 719-333-4998
Mailing address:
  • Phone: 719-481-3454
  • Fax: 719-333-4998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG0811
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: