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630 N Alvernon Way Ste 161 Tucson AZ 85711-1895 | |
(520) 318-9222 | |
(520) 318-9094 |
Full Name | |
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Speciality | Clinic/center - Community Health |
Location | 630 N Alvernon Way Ste 161, Tucson, Arizona |
Authorized Official Name and Position | Paul Axinn (CONTRACTS AND CREDENTIALING MANAGER) |
Authorized Official Contact | 5202021755 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1650 E Fort Lowell Rd Ste 202 Tucson AZ 85719-2378 Ph: (520) 327-4505 | 630 N Alvernon Way Ste 161 Tucson AZ 85711-1895 Ph: (520) 318-9222 |
NPI Number | 1578070447 |
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Provider Enumeration Date | 01/02/2018 |
Last Update Date | 01/02/2018 |
Identifier | Type | State | Issuer |
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1578070447 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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