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NPI Code Detail

MEDICARE: JASON SETH REINGOLD M.D.

MEDICARE: JASON SETH REINGOLD 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
1207RC0000XCardiovascular Disease Physician064255GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1202I06OTHERMEDICARE

General Provider Information

NPI Number : 1639374283
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON SETH REINGOLD M.D.
Provider Business Mailing Address
First Line : 3943 DAHLWINY CT
Second Line :
City : SANDY SPRINGS
State : GA
Zip : 30350-1153
Country : US
Telephone Number : 404-946-8797
Fax Number : 404-595-4650
Provider Business Practice Location Address
First Line : 11680 GREAT OAKS WAY STE 170
Second Line :
City : ALPHARETTA
State : GA
Zip : 30022-2483
Country : US
Telephone Number : 404-900-9970
Fax Number : 770-755-5865
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2007
Last Update Date : 04/20/2023

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