Individual
DR. MARK A RACKISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1705 WARREN AVE, SUITE 101-103, WILLIAMSPORT, PA 17701-2647
(570) 321-2020
(570) 320-7576
Mailing address
1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD045565L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001259522
—
PA
Enumeration date
03/25/2006
Last updated
08/18/2016
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