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General NPI Number Information
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NPI Number | 1477736882
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Entity Type | Organization
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Legal Business Name | MARLA A RECKART, M.D.
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 1200 N EL DORADO PL STE. F-600
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City | TUCSON
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State | AZ
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Zip | 85715-4637
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Country | US
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Telephone | 520-751-8500
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Fax | 520-751-8501
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Provider Business Mailing Address
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Address Line | 1200 N EL DORADO PL STE. F-600
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City | TUCSON
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State | AZ
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Zip | 85715-4637
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Country | US
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Telephone | 520-751-8500
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Fax | 520-751-8501
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARLA A RECKART
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Credential | M.D.
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Telephone | 520-751-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 18709
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License Number State | AZ
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