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General NPI Number Information
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NPI Number | 1184011744
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Entity Type | Individual
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Provider Name | JACOB PAUL REINHART M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 4350 LIMELIGHT AVE # 205
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City | CASTLE ROCK
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State | CO
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Zip | 80109-8034
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Country | US
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Telephone | 720-686-7546
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Fax |
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Provider Business Mailing Address
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Address Line | 1575 OAK HILLS DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-1417
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Country | US
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Telephone | 651-253-2167
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 67857
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | 67857
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | DR.0074642
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number | 0101261323
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License Number State | VA
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