Provider Demographics
NPI:1184011744
Name:REINHART, JACOB PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:PAUL
Last Name:REINHART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 OAK HILLS DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-1417
Mailing Address - Country:US
Mailing Address - Phone:651-253-2167
Mailing Address - Fax:
Practice Address - Street 1:4350 LIMELIGHT AVE # 205
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-8034
Practice Address - Country:US
Practice Address - Phone:720-686-7546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-22
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN67857207N00000X, 207ND0101X
CODR.0074642207ND0101X
VA0101261323171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No171000000XOther Service ProvidersMilitary Health Care Provider