Basic Information
Provider Information
NPI: 1265475354
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REHAK
FirstName: DAVID
MiddleName: C.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 370
Address2:  
City: FORTSON
State: GA
PostalCode: 318080370
CountryCode: US
TelephoneNumber:  
FaxNumber: 7064943008
Practice Location
Address1: 6262 VETERANS PKWY
Address2:  
City: COLUMBUS
State: GA
PostalCode: 319093540
CountryCode: US
TelephoneNumber: 7063246661
FaxNumber: 7064943201
Other Information
ProviderEnumerationDate: 06/14/2006
LastUpdateDate: 11/20/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/20/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000XMD.18041ALN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XS0106XMD.18041ALN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
2086S0105XMD.18041ALN Allopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
2086S0105X038591GAN Allopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
207XS0106X38591GAY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery

No ID Information.


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