Provider Demographics
NPI:1730145459
Name:RIZK, GEORGE THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:THOMAS
Last Name:RIZK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P. O. BOX 10880
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86304
Mailing Address - Country:US
Mailing Address - Phone:928-759-5974
Mailing Address - Fax:916-636-4358
Practice Address - Street 1:1001 WILLOW CREEK RD STE 2200
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1614
Practice Address - Country:US
Practice Address - Phone:928-445-6025
Practice Address - Fax:928-778-3026
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ23395207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
BR1434430OtherDEA NUMBER
F58020Medicare UPIN
BR1434430OtherDEA NUMBER