Provider Demographics
NPI:1447953427
Name:MATTHEW J. RESCHLY, MD, PC
Entity type:Organization
Organization Name:MATTHEW J. RESCHLY, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:RESCHLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:470-273-7233
Mailing Address - Street 1:268 RUMSON RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-3114
Mailing Address - Country:US
Mailing Address - Phone:404-323-4260
Mailing Address - Fax:
Practice Address - Street 1:2000 RIVERSIDE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5926
Practice Address - Country:US
Practice Address - Phone:470-273-7233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Multi-Specialty