Organization
REGENCY RECONSTRUCTION PLLC
Active
Parent organization
REGENCY RECONSTRUCTION PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
REGENCY RECONSTRUCTION PLLC
Authorized official
JASON MUSSMAN MD (PROVIDER/OWNER)
(989) 255-4794
Entity
Organization
Contact information
Practice address
3172 N SWAN RD, TUCSON, AZ 85712-1227
(623) 243-9077
Mailing address
10240 W INDIAN SCHOOL RD STE 115, PHOENIX, AZ 85037-5905
(623) 243-9077
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
444652
—
AZ
Enumeration date
02/22/2021
Last updated
02/22/2021
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