Provider Demographics
NPI:1720517873
Name:REIMER, JONATHAN ANDREW (DO)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:ANDREW
Last Name:REIMER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2500 NORTH STATE STREET
Mailing Address - Street 2:OLD HOSPITAL 3 SOUTH ROOM S376
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4500
Mailing Address - Country:US
Mailing Address - Phone:617-997-3196
Mailing Address - Fax:
Practice Address - Street 1:2500 N STATE STREET
Practice Address - Street 2:OLD HOSPITAL 3 SOUTH, ROOM S376
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:601-984-6603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-11
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.070609208600000X
MS33255208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery