Provider Demographics
NPI:1316174022
Name:REICHERT, BRYAN KENT (MD)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:KENT
Last Name:REICHERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1600 FISH HATCHERY RD
Mailing Address - Street 2:
Mailing Address - City:ESTES PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80517-9227
Mailing Address - Country:US
Mailing Address - Phone:970-586-4491
Mailing Address - Fax:970-577-0392
Practice Address - Street 1:1600 FISH HATCHERY RD
Practice Address - Street 2:
Practice Address - City:ESTES PARK
Practice Address - State:CO
Practice Address - Zip Code:80517-9227
Practice Address - Country:US
Practice Address - Phone:970-586-4491
Practice Address - Fax:970-577-0392
Is Sole Proprietor?:No
Enumeration Date:2009-06-20
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46447207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO10328779Medicaid