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General NPI Number Information
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NPI Number | 1891082152
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Entity Type | Organization
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Legal Business Name | REITZ NEUROLOGY PLLC
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 07/06/2011
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Provider Practice Location Address
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Address Line | 1204 W WILLOW RD SUITE C
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City | ENID
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State | OK
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Zip | 73703-2531
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Country | US
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Telephone | 580-237-0549
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Fax | 580-237-7851
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Provider Business Mailing Address
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Address Line | 1204 W WILLOW RD SUITE C
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City | ENID
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State | OK
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Zip | 73703-2531
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Country | US
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Telephone | 580-237-0549
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Fax | 580-237-7851
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Authorized Official
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Title or Position | MEMBER
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Name | ROLFE DEAN REITZ
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Credential | M.D.
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Telephone | 580-237-0549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 13807
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License Number State | OK
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