MEDICARE: JENNIFER REHBEIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	13398090-1205	UT

General Provider Information

NPI Number	:	1134618374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER REHBEIN MD

Provider Business Mailing Address
First Line	:	PO BOX 100253
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-0253
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 E 3900 S STE 460
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84124-1349
Country	:	US
Telephone Number	:	801-262-3564
Fax Number	:	801-262-3613

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2018
Last Update Date	:	08/10/2023

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