Healthcare Provider Details

I. General information

NPI: 1609861137
Provider Name (Legal Business Name): CHRIS RECKNOR, M.D. PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 12/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 LIMESTONE PKWY
GAINESVILLE GA
30501-2087
US

IV. Provider business mailing address

PO BOX 908063
GAINESVILLE GA
30501-0916
US

V. Phone/Fax

Practice location:
  • Phone: 770-534-5154
  • Fax: 770-503-0183
Mailing address:
  • Phone: 770-534-5154
  • Fax: 770-503-0183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER P RECKNOR
Title or Position: OWNER
Credential: M.D.
Phone: 770-534-5154