| Infectious Disease Southwest | |
|
2300 S Houghton Rd Ste 250 Tucson AZ 85748-0002 | |
| (520) 231-4379 | |
| (520) 677-4379 |
| Full Name | Infectious Disease Southwest |
|---|---|
| Speciality | Internal Medicine |
| Location | 2300 S Houghton Rd Ste 250, Tucson, Arizona |
| Authorized Official Name and Position | Logan Felix (OWNER) |
| Authorized Official Contact | 5202314379 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Disease Southwest 2300 S Houghton Rd # 250 Tucson AZ 85748-0002 Ph: (520) 231-4379 | Infectious Disease Southwest 2300 S Houghton Rd Ste 250 Tucson AZ 85748-0002 Ph: (520) 231-4379 |
| NPI Number | 1467224345 |
|---|---|
| Provider Enumeration Date | 10/24/2023 |
| Last Update Date | 04/24/2024 |
| Medicare PECOS PAC ID | 2264885029 |
|---|---|
| Medicare Enrollment ID | O20240129000106 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467224345 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Logan Paolo Felix |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1194038505 PECOS PAC ID: 2668773771 Enrollment ID: I20181119003326 |
| Provider Name | Porntip Kiatsimkul |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205099082 PECOS PAC ID: 4284804576 Enrollment ID: I20240305002011 |
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