Provider Demographics
NPI:1487690350
Name:RENO FAMILY PHYSICIANS JENNIFER HORNBACK MD, ETAL,LTD
Entity type:Organization
Organization Name:RENO FAMILY PHYSICIANS JENNIFER HORNBACK MD, ETAL,LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNBACK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-851-5700
Mailing Address - Street 1:7111 S VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511
Mailing Address - Country:US
Mailing Address - Phone:775-851-5700
Mailing Address - Fax:775-851-5727
Practice Address - Street 1:7111 S VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511
Practice Address - Country:US
Practice Address - Phone:775-851-5700
Practice Address - Fax:775-851-5727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
30931Medicare ID - Type UnspecifiedGROUP