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Individual

MARVIN T RACOWSKY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
8260 W INDIAN SCHOOL RD, PHOENIX, AZ 85033
(632) 846-7122
(623) 846-7027
Mailing address
PO BOX 32950, PHOENIX, AZ 85064-2950
(602) 433-1822
(602) 246-7060

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1229
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
154873
AZ
01
67566
MEDICARE PIN #
AZ
Enumeration date
02/13/2006
Last updated
07/08/2007
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