Organization
DANIEL J REICHENBACH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL J REICHENBACH M.D. (PRESIDENT)
(912) 265-0492
Entity
Organization
Contact information
Practice address
3020 SHRINE RD, BRUNSWICK, GA 31520-4743
(912) 267-0533
(912) 267-7313
Mailing address
3226 HAMPTON AVE, STE B, BRUNSWICK, GA 31520-4225
(912) 265-0492
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
056472
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10062814
AMERIGROUP
GA
01
—
11625808
CAQH
GA
01
—
344048
WELLCARE
GA
Enumeration date
07/02/2007
Last updated
11/02/2007
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