Provider Demographics
NPI:1003994534
Name:REESE, GARY NORMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:NORMAN
Last Name:REESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7242 E. OSBORN ROAD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6435
Mailing Address - Country:US
Mailing Address - Phone:602-258-3354
Mailing Address - Fax:602-258-3368
Practice Address - Street 1:7242 E. OSBORN ROAD
Practice Address - Street 2:SUITE 400
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6435
Practice Address - Country:US
Practice Address - Phone:602-258-3354
Practice Address - Fax:602-258-3368
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ123362084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD37499Medicare UPIN
AZ13WCFGN01Medicare ID - Type UnspecifiedMEDICARE NUMBER