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NPI Code Detail

MEDICARE: DR. MICHAEL L RECKTENWALD P.D.

MEDICARE:  DR. MICHAEL L RECKTENWALD  P.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistAR6928AR

General Provider Information

NPI Number : 1942296900
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL L RECKTENWALD P.D.
Provider Business Mailing Address
First Line : 18 PEBBLECREEK DR
Second Line :
City : MOUNTAIN HOME
State : AR
Zip : 72653-5701
Country : US
Telephone Number : 870-424-3780
Fax Number :
Provider Business Practice Location Address
First Line : 624 HOSPITAL DR
Second Line : EMPLOYEE PHARMACY DEPARTMENT
City : MOUNTAIN HOME
State : AR
Zip : 72653-2955
Country : US
Telephone Number : 870-508-7388
Fax Number : 870-508-1354
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2005
Last Update Date : 07/08/2007

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Directions to “ DR. MICHAEL L RECKTENWALD P.D.” Practice Location

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