Individual
MARK GARRETT RIEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7219 N LITCHFIELD RD, 56TH MEDICAL GROUP, LUKE AFB, AZ 85309-1529
(623) 856-4396
Mailing address
7219 N LITCHFIELD RD, 56TH MEDICAL GROUP, LUKE AFB, AZ 85309-1529
(623) 856-4396
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01054970A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01054970A
STATE MEDICAL LICENSE
IN
Enumeration date
10/18/2005
Last updated
06/09/2016
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