Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 12336 | AZ |
NPI | 1003994534 |
---|---|
Provider Name | Dr. Gary Norman Reese |
First Address | Scottsdale, AZ 85251-6435 |
Second Address | Scottsdale, AZ 85251-6435 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 29/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D37499 | (02) | AZ |