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NPI Code Detail

MEDICARE: GREGORY C REICKS D.O.

MEDICARE:   GREGORY C REICKS  D.O.
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
1207Q00000XFamily Medicine Physician29342CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2080032251OTHERCORAIL ROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3REU8418OTHERCOBLUE CROSS BLUE SHIELD
429342OTHERCOMEDICAL LICENSE NUMBER

General Provider Information

NPI Number : 1326049321
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY C REICKS D.O.
Provider Business Mailing Address
First Line : 2503 FORESIGHT CIRCLE
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81505
Country : US
Telephone Number : 970-242-2660
Fax Number : 970-242-4917
Provider Business Practice Location Address
First Line : 2570 PATTERSON RD
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81505-1438
Country : US
Telephone Number : 970-298-6601
Fax Number : 970-298-6641
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 10/14/2021

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Directions to “ GREGORY C REICKS D.O.” Practice Location

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