Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 6967 | AZ |
N | 111NI0900X | Internist | 6967 | AZ |
N | 207U00000X | Nuclear Medicine Specialist | 6967 | AZ |
NPI | 1033212972 |
---|---|
Provider Name | Dr. Frederick Elmer Reinke |
First Address | Benton, LA 71006-9425 |
Second Address | Shreveport, LA 71101-4243 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 08/07/2007 |