Basic Information
| Provider Information | |||||||||
| NPI: | 1720460769 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEVITIS | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | NICHOLAS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 13627 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857323627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207507255 | ||||||||
| FaxNumber: | 5205457261 | ||||||||
| Practice Location | |||||||||
| Address1: | 1951 N WILMOT RD STE 2 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857128000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207955845 | ||||||||
| FaxNumber: | 5207958620 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2015 | ||||||||
| LastUpdateDate: | 10/19/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 4301108141 | MI | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0102X | 63328 | AZ | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 208600000X | 63328 | AZ | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.