# DR RICK SHACKET PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215263850
- **Authorized official:** DR. RICK SHACKET D.O. (OWNER)
- **Authorized official phone:** (602) 492-9919

## Contact information

- **Practice address:** 1525 N GRANITE REEF RD STE 12, SCOTTSDALE, AZ 85257-3998
- **Practice address phone:** (602) 492-9919
- **Practice address fax:** (602) 263-3697
- **Mailing address:** 8 BILTMORE EST UNIT 201, PHOENIX, AZ 85016-2839
- **Mailing address phone:** (602) 920-1023
- **Mailing address fax:** (602) 263-3697

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | 4257 | AZ | — |
| 208C00000X | Colon & Rectal Surgery Physician | 4257 | AZ | Yes |

## Other

- **Enumeration date:** 11/01/2009
- **Last updated:** 11/22/2024