Provider Demographics
NPI:1144498635
Name:VISCUSI, REBECCA KLEIN (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:KLEIN
Last Name:VISCUSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:LYN
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 910221
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-0221
Mailing Address - Country:US
Mailing Address - Phone:520-519-7775
Mailing Address - Fax:
Practice Address - Street 1:2625 N CRAYCROFT RD STE 201
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2268
Practice Address - Country:US
Practice Address - Phone:520-324-2778
Practice Address - Fax:520-324-2204
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ43542208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery