MEDICARE: JENNIFER LEIGH REECE HARTZ M.D.

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	208000000X	Pediatrics Physician	2010-01112	NC

General Provider Information

NPI Number	:	1245433929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LEIGH REECE HARTZ M.D.

Provider Business Mailing Address
First Line	:	433 W MEADOWVIEW RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27406-4316
Country	:	US
Telephone Number	:	336-370-9091
Fax Number	:	336-370-4992

Provider Business Practice Location Address
First Line	:	433 W MEADOWVIEW RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27406-4316
Country	:	US
Telephone Number	:	336-370-9091
Fax Number	:	336-370-4992

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

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	02/16/2011

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