Basic Information
| Provider Information | |||||||||
| NPI: | 1487804399 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | T BRYSON STRUSE DO PLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 27340 | ||||||||
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| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850617340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6029439200 | ||||||||
| FaxNumber: | 6022163026 | ||||||||
| Practice Location | |||||||||
| Address1: | 4892 N STONE AVE | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857045761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206962300 | ||||||||
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| ProviderEnumerationDate: | 09/27/2008 | ||||||||
| LastUpdateDate: | 09/27/2008 | ||||||||
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| AuthorizedOfficialLastName: | STRUSE | ||||||||
| AuthorizedOfficialFirstName: | T | ||||||||
| AuthorizedOfficialMiddleName: | BRYSON | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5206962300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207UN0901X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology |
No ID Information.